Cervical Cancer Screening: American College of Preventive Medicine Practice Policy Statement

Hawkes, Allison P.; Kronenberger, Crystal B.; MacKenzie, Thomas D.; Mardis, Anne L.; Palen, Ted E.; Schulter, Walter W.; Shah, Seema A.; Steele, Andrew; Marine, Willliam M.

doi:10.1016/s0749-3797(18)30290-3

Cited by 15 publications

(4 citation statements)

References 11 publications

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“…It showed that it would not be consistent to stop screening these women while not also relaxing the screening policy for younger women with similar screening histories. In this respect, our conclusion lends support to the current cervical cancer screening guidelines in England and other developed countries,36 39 40 41 42 which do not discriminate women by age up to 60-65.…”

Section: Discussionsupporting

confidence: 77%

Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

Rebolj

Ballegooijen

Lynge

et al. 2009

BMJ

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Objective To determine the incidence of cervical cancer after several negative cervical smear tests at different ages. Design Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry of histopathology and cytopathology (PALGA). Setting Netherlands, national data. Population 218 847 women aged 45-54 and 445 382 aged 30-44 at the time of the third negative smear test. Main outcome measures 10 year cumulative incidence of interval cervical cancer. Results 105 women developed cervical cancer within 2 595 964 woman years at risk after the third negative result at age 30-44 and 42 within 1 278 532 woman years at risk after age 45-54. During follow-up, both age groups had similar levels of screening. After 10 years of followup, the cumulative incidence rate of cervical cancer was similar: 41/100 000 (95% confidence interval 33 to 51) in the younger group and 36/100 000 (24 to 52) in the older group (P=0.48). The cumulative incidence rate of cervical intraepithelial neoplasia grade I+ was twice as high in the younger than in the older group (P<0.001). Conclusions The risk for cervical cancer after several negative smear results by age 50 is similar to the risk at younger ages. Even after several negative smear results, age is not a good discriminative factor for early cessation of cervical cancer screening.

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Section: Discussionsupporting

confidence: 77%

Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

Rebolj

Ballegooijen

Lynge

et al. 2009

BMJ

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show abstract

“…25, 27, 30 Without definitive information as to an upper age limit at which screening is no longer clinically or financially effective, 4 there continues to be a lack of clear screening guidelines for elderly women, particularly with respect to cervical cancer screening. 2, 6, 18…”

Section: Discussionmentioning

confidence: 99%

“…Many asymptomatic women, however, underutilize screening, whereby they never obtain the screening procedures or do not follow the recommended schedules (annual clinical breast examinations [CBE] and mammography after age 40 5 and Pap smears every 1 to 2 years after age 18). 2, 4, 6 In Florida, the 1997 Behavioral Risk Factor Surveillance Survey indicated that within the past 2 years, 77.7% of women older than 50 reported receiving mammography, and 76.3% of women older than 50 with an intact uterus reported receiving Pap smears. 7 Underutilization of screening is especially prevalent among medically underserved women, who are often elderly, poor, unmarried, of minority status, residents of rural settings, and limited in years of education.…”

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confidence: 99%

A Provider Survey

1998

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The authors recommend that public health and primary care practitioners collaborate in developing strategies that address areas of potential change for overcoming these four barriers, while also considering the essential public health services of assessment, policy development, and assurance. These strategies should be designed to facilitate the breast and cervical cancer screening process for both providers and patients, so that providers feel more comfortable performing and recommending these important tests, particularly for underserved groups of older women.

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“…7-9 Decision analysis and cost-effectiveness analysis also integrate multiple data sources and information to determine policy. 10,11 The decision-analytic approach has influenced professional organizations including the American College of Physicians and the American Can-cerSociety, [12][13][14] andithasbeenrecognized by the Agency for Health Care Policy and Research as central to the task of guideline development. 15 For both of these ap-Author Affiliations: Program on the Economic Evalu-…”

mentioning

confidence: 99%

Expert Panel vs Decision-Analysis Recommendations for Postdischarge Coronary Angiography After Myocardial Infarction

Kuntz

Tsevat

Weinstein

et al. 1999

JAMA

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For the 36 expert panel scenarios that could be simulated by the decision-analytic model, there was moderate to good agreement between the appropriateness score and both the health gain and the incremental cost-effectiveness ratio of coronary angiography compared with no angiography in the convalescent phase of acute myocardial infarction, but several scenarios judged as inappropriate by the expert panel approach had cost-effectiveness ratios comparable with many generally recommended medical interventions. Formal synthesis of expert judgment and decision modeling is warranted in future efforts at guideline development.

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Cervical Cancer Screening: American College of Preventive Medicine Practice Policy Statement

Cited by 15 publications

References 11 publications

Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

A Provider Survey

Expert Panel vs Decision-Analysis Recommendations for Postdischarge Coronary Angiography After Myocardial Infarction

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