Australian and New Zealand Journal of Public Health

A methodology was developed to support a comprehensive health services research project undertaken to monitor and evaluate the practice of in vitro fertilization (IVF) and related procedures, such as GIFT, in Western Australia (WA) from 1983 to 1987. The project included demographic, clinical and economic assessments of the new technology. The study subjects were the 1,240 couples who began IVF treatment between January 1, 1983 and December 30, 1986. Information was collected on all 2,982 treatment cycles commenced by June 30, 1987, and on the 273 births that resulted from these treatment cycles. Where relevant, comparisons were based on information obtained from the Australian Bureau of Statistics (ABS) census, the WA Midwives' Notification System and the WA Hospital Morbidity Data System. The need for long‐term follow‐up studies of children and participants is identified, as is the need for randomized clinical trials to evaluate more fully the success of the procedures where bilateral tubal blockage is not the indication for the treatment.

Age specific rates for Papanicolaou smears by the Victorian Cytology (Gynaecological) Service (VCGS) during 1971 to 1986 are presented. There was a dramatic increase in smear rates for women aged less than 35 years during the period studied.

Conversely, for postmenopausal women maximum smear rates were achieved in 1971 with a steady decline thereafter. In women over the age of 55 years, the 1986 smear rates were approximately half the 1971 rates. The pronounced decline in smear rates in older women is particularly worrying as these women constitute the age group with the highest incidence rates for cervical cancer.

The highest rate for any age group occurred in 1976 when 357 women per 1000 female residents in the age group 35–39 years were screened. Smears were received from an estimated 18.3 percent of the resident female population of Victoria during 1986. A longitudinal study of subsequent use of cervical cytology by women having negative smears in 1971 is in progress.