Amenorrhoea after oral contraceptives

and five years after the birth of the last child routine recall should start. The fall in detection rates among women repeatedly presenting themselves for rescreening is so dramatic12 that a limit could be put on rescreening. Multiphasic screening has already been criticised,13 and the Canadians agree that it is not realistic. For example, to link cervical screening with screening for breast cancer is unreasonable, because the epidemiological characteristics of women in the high risk group for cervical cancer are completely different from those ofwomen at high risk for breast cancer, but the two might be linked when the women concerned reach 50 years of age. Nevertheless, this would link the finding of a condition which can be reasonably expected to be prevented or cured with a condition which is invasive at the time of detection and probably will not be cured. The detection of a few cases of unsuspected endometrial cancer is a bonus seldom mentioned in cervical screening. That cervical cancer is a disease which can be limited successfully and even prevented is the conclusion of the Canadian report. Nevertheless, a high incidence of the disease is found'4 in known and unknown defaulters to a screening programme, and also a significant number of cases occurs in women who have been inadequately screened. A few cases of cervical cancer will therefore always occur.