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The present study was designed to determine the Pap screening histories of 261 women, ages 20 through 69 years, who were diagnosed with an invasive carcinoma of the uterine cervix. Women who were residents of New York State, exclusive of New York City, and who received a diagnosis between July 1983 and September 1985, were selected for this study. Fifty-four percent of the patients had not received at least one Pap test within three years prior to diagnosis. Women who had not received a prior Pap smear tended to be older, less sexually active, less well educated, and to have more extensive disease at the time of diagnosis than women who had received cytologic examinations. The present study results, coupled to findings of previous reports, demonstrate the need for an intensified effort to insure that all women have access to quality Pap screening services. Particular emphasis needs to be placed on reaching older women who are less likely than younger ones to receive periodic Pap screening. Physicians need to routinely offer older patients who present with nongynecologic conditions the opportunity of receiving cytologic testing.

A population-based case-control study was conducted with 403 white, ovarian cancer patients, 20-79 years of age, who were diagnosed from October 1977 through February 1980 in 11 New York State counties. The study also included 806 controls who were matched to the cases by age, race, and county of residence. The contraceptive and reproductive patterns observed in this study suggest that infertility plays an important role in determining the relationship between reduced parity and gravidity and increased ovarian cancer risk. Ovarian cancer patients were less likely than controls to have ever used nonpermanent birth control methods (relative risk = 0.63, 95% confidence interval = 0.45-0.89), and they tended to practice contraception less often. A direct graded-response relationship was observed between ovarian cancer risk and the number of contraceptive-free years of marriage (chi 2 Linear trend = 5.911, p = 0.02). An inverse graded-response relationship was observed between gravidity and risk. This relationship persisted even after contraception was taken into account (chi 2 Linear trend = 13.002, p = 0.0003). Ovarian cancer risk was not found to be associated with an excess in reported fetal loss.