To determine how many women diagnosed with cervical carcinoma had cervical cytology in the years preceding their diagnosis, whether they had participated in population-based screening for cervical neoplasia and what advice was given based on the cytology.

Retrospective cohort study.

The Nationwide Network and Registry of Histo- and Cytopathology in the Netherlands (PALGA) was searched for records of 30- to 67-year-old women with squamous cell cancer and adenocarcinoma of the uterine cervix diagnosed in 2006 and 2007. All these records were checked for cytolgy in the history up to 5 years prior to the diagnosis. If the patient had participated in the screening programme, the advice following cervical cytology was established.

In PALGA, 1037 cases of squamous cell cancer or adenocarcinoma of the uterine cervix were found. In 349 women (34%), no cytology had been performed up to 5 years prior to the diagnosis, whereas 688 women (66%) had had cytology. Of these, 493 were carried out in the context of the screening programme and 195 for other reasons. For 476 women who had taken part in the screening programme, the nature of the advice given following cytology was determined. In 178 women (37%) cytology was not abnormal, while 298 women (63%) had to have cytology again or were referred for colposcopy.

Of women with cervical cancer, still too many do not undergo screening (34%), considering the regular coverage in the screening programme (77%). Of the women participating in the screening programme, 37% had a result indicating no dysplasia, probably suggesting a false negative result.