Cervical cytology smears in sexually transmitted infection clinics in the United Kingdom.

OBJECTIVES To determine the current practice of smear taking in sexually transmitted infection (STI) clinics within the United Kingdom; what proportion of smears are taken within the national guidelines; whether clinics are screening women not covered by the national screening programme. To compare the abnormality rates of routine and opportunistic (that is, in addition to the screening recommendations) smears; the abnormality rates of smears taken within STI clinics with those taken within the community setting. METHODS A questionnaire was circulated to all clinics in May 1998. Details of screening practice were requested. The clinics then prospectively collected details of patient's age, GP registration, date and result of previous smear, and current result of all smears taken between 11 May 1998 and 25 May 1998. RESULTS There were 1828 smears taken in the 2 week period; 504 (27.6%) were opportunistic. Opportunistic smears had marginal significantly increased rates of low grade abnormalities but lower (but not statistically significant) high grade abnormalities than in routine smears. 231 (12.6%) of the women were not registered with a GP so would not be included in the national programme. The national rates of abnormalities were significantly higher in the STI clinics compared with the community setting. CONCLUSION The majority of smears taken within STI clinics fall within the national guidelines, and 12.6% of the women would probably not otherwise have been screened. The rates of abnormality were significantly higher in the STI clinics but smears taken opportunisticly were less likely to have high grade abnormalities. There is no evidence from this study to support the practice of additional smears in the presence of an effective national cytology screening programme.