Abstract
Background
Cervical cancer screening, which was introduced into the programme of medical care
covered by statutory health insurance in Germany in 1971 and has since been constantly
updated through
quality assurance measures, was fundamentally revised and developed in 2008 through
the Cervical Cytology Quality Assurance Agreement pursuant to Section 135(2) of the
German Social Code
Book V [SGB V]. Since 2015 it has been mandatory for cytology facilities to record
annual statistics based on the Munich Nomenclature III. The aim of this article is
to present the results
of the annual statistics for 2019, which was the last year before the introduction
of the cervical cancer screening programme in accordance with the Federal Joint Committee’s
guideline on
organised cancer screening programmes [1].
Materials and Methods
The annual statistics of the laboratories, including histology analyses performed
up until 30 June the following year, are reported to the Regional Associations of
Statutory Health
Insurance Physicians. The laboratories receive benchmark reports from their Regional
Associations of Statutory Health Insurance Physicians, and these statistics are transmitted
anonymously
to the National Association of Statutory Health Insurance Physicians (KBV).
Results
In 2019, 17609082 smears from 15608413 women were examined in Germany. Of these smears,
97.49% were normal and 2.51% showed atypical or suspicious changes, consisting mostly
of minor
squamous epithelial changes in groups II-p (0.81%) and IIID1 (0.735%).
Histology specimens are available for “Dysplasia findings with higher probability
of regression” in group IIID1 (4.89% of initial IIID1 cytology findings), group IIID2
(18.60%), “unclear
or doubtful findings” in group III-p to x (20.7%), and “immediate precursors to cervical
carcinoma” in group IV (83.1%) and group V (77.19%).
In the cytology findings for group IVa-p, which corresponds to CIN 3 target lesions,
the cytology correlated with the histology finding in 80.48% of cases.
Lesions found in 2019: 23463 CIN 3 lesions, 668 adenocarcinomas in situ, 3891 malignant
tumours, including 2342 cervical carcinomas of which 1743 were squamous cell carcinomas
and 599
were cervical adenocarcinomas (25.57%); 1549 endometrial carcinomas and other malignancies.
Inference/Conclusion
The data demonstrate the good practicability of cervical cancer screening in 2019.
Higher grade lesions were reliably clarified histologically.
Keywords
cervical cancer - precancerous cervical lesions - epidemiology - cervix - quality
assurance - cytology
