Medical history of invasive cervical carcinoma. Symptoms and medical care in 87 cases

: The history of 87 patients suffering from invasive cervical cancer was taken using a special pattern of questions at the time of the patient's clinical admittance. After a minimum of two years after therapy the course of the disease was evaluated in each case and compared to the history and the stage of the tumor. The symptoms "postcoital bleeding" and "metrorrhagia" were found in different frequency in a significant dependence of the stage of the tumor. 26 patients (30%) had undergone a gynecologic examination without suspicion of malignancy within two years before clinical admittance, 18 of them in combination with a routine "PAP-smear". 15 patients reported the last unsuspicious examination even within the last year before clinical admittance. In this group of patients the highest rates of pelvic lymph node involvement (33,3%) and of mortality from recurrence (26,7%) were found. This surprising fact can be seen as evidence for a second form of cervical cancer with rapid invasive growth which may apart from false negative cytologic results be responsible for apparent failures of preventive care.