Excess Cost of Cervical Cancer Screening Beyond Recommended Screening Ages or After Hysterectomy in a Single Institution

Teoh, Deanna; Hultman, Gretchen M.; DeKam, McKenzie; Downs, Levi S.; Geller, Melissa A.; Le, Chap T.; Melton, Genevieve B.; Kulasingam, Shalini

doi:10.1097/lgt.0000000000000400

Cited by 11 publications

(8 citation statements)

References 21 publications

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“… 29 Lastly, false-positive screening tests add cost to the health care system with minimal additional health benefit. 30 To date, HPV primary or cotesting has not been recommended in the youngest screening age group because of a high infection prevalence with subsequent clearance. However, as vaccination against HPV increases and the prevalence of HPV infection decreases, incorporation of HPV testing in this age group may need to be reconsidered, with focus on its negative predictive value (ie, identification of individuals at the lowest risk of CIN 2 or a more severe diagnosis) to identify a group requiring the least intensive screening strategy.…”

Section: Discussionmentioning

confidence: 99%

“…29 Lastly, false-positive screening tests add cost to the health care system with minimal additional health benefit. 30 However, it is notable that in 2020 there were still states where vaccination coverage among female residents was less than 50%. 13…”

Section: Discussionmentioning

confidence: 99%

“…Studies have shown anxiety associated with an abnormal screening test result can last up to 24 months, even after a subsequent normal diagnostic test result . Lastly, false-positive screening tests add cost to the health care system with minimal additional health benefit . To date, HPV primary or cotesting has not been recommended in the youngest screening age group because of a high infection prevalence with subsequent clearance.…”

Section: Discussionmentioning

confidence: 99%

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Test Performance of Cervical Cytology Among Adults With vs Without Human Papillomavirus Vaccination

et al. 2022

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Key Points Question Is the positive predictive value of abnormal cervical cytology lower among individuals who have been vaccinated against human papillomavirus? Findings In a cohort study of 46 988 patients aged 21 to 35 years participating in cervical cancer screening, the positive predictive value of cervical cytology for cervical intraepithelial neoplasia 2 and more severe diagnoses was significantly lower among vaccinated individuals (17.4%) than unvaccinated individuals (21.3%). Meaning The observed increased risk of a false-positive cervical cytology result for individuals vaccinated against HPV may warrant screening guidelines that stratify by vaccination status to minimize the risks of overscreening and overtreatment among individuals with low risk for cervical cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Test Performance of Cervical Cytology Among Adults With vs Without Human Papillomavirus Vaccination

et al. 2022

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“…Emerging evidence suggests cervical cancer is caused by genetic and epigenetic changes as well as different kinds of environmental factors [1,2]. Advances in cervical cancer therapy over the past decade have enhanced patient outcomes, and the 5-year survival rate of cervical cancer patients has been dramatically improved [3]. However, the outcome remains poor and most of them died of long-term metastases eventually [2].…”

Section: Introductionmentioning

confidence: 99%

MiR-34b regulates cervical cancer cell proliferation and apoptosis

Zhi-min

Zhang

Xie

et al. 2019

Artificial Cells, Nanomedicine, and Biotechnology

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Objectives: MiR-34b is a tumour suppressor in different kinds of carcinomas. This study investigated the role of miR-34b in proliferation and apoptosis of cervical cancer. Materials and methods: The expression of miR-34b in 60 cervical cancer patients were quantified by RT-PCR and correlated with their clinicopathological parameters. Besides, there is a significant reverse relationship between miR-43b and TGF-β1 expression in tumour tissues. Cell proliferation and apoptosis was detected by CCK-8 assays and flow cytometry in cell lines transfected with miR-34b mimics. Western blotting, quantitative reverse transcription-PCR (RT-PCR) and luciferase assays were conducted to analyze the regulation of TGF-β1 by miR-34b in cell lines. Results: Here, we found expression of miR-34b to be downregulated in cervical cancer in comparison with the adjacent normal tissues. Expression levels of miR-34b were associated with enhanced malignant potential, such as tumour stage and stromal invasion. The overexpression of miR-34b potently suppressed cell proliferation and induced the apoptosis of cell lines. Conclusions: MiR-34b and TGF-β1 contribute to cervical cancer cell proliferation and apoptosis and are potential targets for cervical cancer therapeutics.

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“…Overuse of screening tests for cancer has also been documented 14. Examples include inappropriate screening for cervical cancer,15 mammography screening for breast cancer16 17 and thyroid cancer screening 18–20…”

Section: Introductionmentioning

confidence: 99%

Can nudge-interventions address health service overuse and underuse? Protocol for a systematic review

et al. 2019

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IntroductionNudge-interventions aimed at health professionals are proposed to reduce the overuse and underuse of health services. However, little is known about their effectiveness at changing health professionals’ behaviours in relation to overuse or underuse of tests or treatments.ObjectiveThe aim of this study is to systematically identify and synthesise the studies that have assessed the effect of nudge-interventions aimed at health professionals on the overuse or underuse of health services.Methods and analysisWe will perform a systematic review. All study designs that include a control comparison will be included. Any qualified health professional, across any specialty or setting, will be included. Only nudge-interventions aimed at altering the behaviour of health professionals will be included. We will examine the effect of choice architecture nudges (default options, active choice, framing effects, order effects) and social nudges (accountable justification and pre-commitment or publicly declared pledge/contract). Studies with outcomes relevant to overuse or underuse of health services will be included. Relevant studies will be identified by a computer-aided search of the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library), MEDLINE, CINAHL, Embase and PsycINFO databases. Two independent reviewers will screen studies for eligibility, extract data and perform the risk of bias assessment using the criteria recommended by the Cochrane Effective Practice and Organisation of Care (EPOC) group. We will report our results in a structured synthesis format, as recommended by the Cochrane EPOC group.Ethics and disseminationNo ethical approval is required for this study. Results will be presented at relevant scientific conferences and in peer-reviewed literature.

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Excess Cost of Cervical Cancer Screening Beyond Recommended Screening Ages or After Hysterectomy in a Single Institution

Abstract: Guideline nonadherent cervical cancer screening in women beyond the recommended screening ages and posthysterectomy resulted in costs exceeding US $160,000 for screening, diagnostic tests, and follow-up with minimal improvement in detection of high-grade dysplasia.

Cited by 11 publications

References 21 publications

Test Performance of Cervical Cytology Among Adults With vs Without Human Papillomavirus Vaccination

Test Performance of Cervical Cytology Among Adults With vs Without Human Papillomavirus Vaccination

MiR-34b regulates cervical cancer cell proliferation and apoptosis

Can nudge-interventions address health service overuse and underuse? Protocol for a systematic review

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