Echelon local du Service médical du régime général de l'Assurance-Maladie des Bouches-du-Rhône, 56, chemin Joseph-Aiguier, 13009 Marseille.
Objective:The aim of this study is to evaluate if the seriousness of invasive neoplasms of the uterin cervix actually observed is related to the apparition of rapid onset cases. Population: 219 invasive cancers of the cervix treated from 1988 to 1999 in a gynecological oncologic department. Methods: pronostic factors of cancers have been studied and compared to those of cases treated beetween 1975 and 1980 in the same department. The existence of cytological screenings has been searched and results have been analysed. Results: Cervical cancers treated during the last 12 years have more serious pronostic factors than those treated during the former period. This evolution is shown by a progression of advanced stages of + 10.2%, an increase of lymph node invasion in proximal stages of + 13,4% and the doubling of number of adenocarcinomas. Though no change of the natural history of cancers has been proved. Only 42% of patients had profited of a cervical screening and cancers diagnosed at "stage I" are statistically more numerous in this group. Improvement should be brought up in the quality of samplings and of the care of abnormal results of cytological screening.