Cancer of the cervix in an Amish population

The records of 10,314 Papanicolaou smears were analyzed to determine the incidence of cervical cancer among the rural inhabitants of Holmes County, Ohio. These examinations, obtained from 1950 to 1966, included smears from two populations of women; 3606 were considered typical of rural U.S. populations wheras 2068 were members of a highly chaste and religious group widely known as the Amish. The incidence of cancer of the cervix was considerably lower among Amish women in spite of a higher birth rate and the absence of contraceptives. Socioeconomic and medical standards are similar in the two groups but the Amish have practiced strict endogamy with monogamous marital behavior for many generations, perhaps limiting the spread of some agent important in the etiology of cervical cancer.