National Cancer Institute®
Last Modified: June 1, 2002
UI - 12020301
AU - Nelson DE; Bland S; Powell-Griner E; Klein R; Wells HE; Hogelin G; Marks
TI - JS State trends in health risk factors and receipt of clinical preventive services among US adults during the 1990s.
SO - JAMA 2002 May 22-29;287(20):2659-67
AD - National Cancer Institute, Division of Cancer Control and Population Sciences, 6130 Executive Blvd, MSC 7365, EPN 4068, Bethesda, MD 20892-7365, USA. firstname.lastname@example.org
CONTEXT: Monitoring trends is essential for evaluating past activities and guiding current preventive health program and policy efforts. Although tracking progress toward national health goals is helpful, use of national estimates is limited because most preventive health care activities, policies, and other efforts occur at the state or community level. There may be important state trends that are obscured by national data. OBJECTIVE: To estimate state-specific trends for 5 health risk factors and 6 clinical preventive services. DESIGN: Telephone surveys were conducted from 1991 through 2000 as part of the Behavioral Risk Factor Surveillance System. SETTING AND PARTICIPANTS: Randomly selected adults aged 18 years or older from 49 US states. Annual state sample sizes ranged from 1188 to 7543. MAIN OUTCOME MEASURES: Statistically significant changes (P<.01) in state prevalences of cigarette smoking, binge alcohol use, physical inactivity, obesity, safety belt use, and mammography; screening for cervical cancer, colorectal cancer, and cholesterol levels; and receipt of influenza and pneumococcal disease vaccination. RESULTS: There were statistically significant increases in safety belt use for 39 of 47 states and receipt of mammography in the past 2 years for women aged 40 years or older for 43 of 47 states. For persons aged 65 years or older, there were increases in receipt of influenza vaccination for 44 of 49 states and ever receiving pneumococcal vaccination for 48 of 49 states. State trends were mixed for binge alcohol use (increasing in 19 of 47 states and declining in 3), physical inactivity (increasing in 3 of 48 states and declining in 11), and cholesterol screening (increasing in 13 of 47 states and decreasing in 5). Obesity increased in all states and smoking increased in 14 of 47 states (declining only in Minnesota). Cervical cancer screening increased in 8 of 48 states and colorectal cancer screening increased in 13 of 49 states. New York experienced improvements for 8 of 11 measures, while 7 of 11 measures improved in Delaware, Kentucky, and Maryland; in contrast, Alaska experienced improvements for no measures and at least 4 of 11 measures worsened in Iowa, North Dakota, and South Dakota. CONCLUSIONS: Most states experienced increases in safety belt use, mammography, and adult vaccinations. Trends for smoking and binge alcohol use are disturbing, and obesity data support previous findings. Trend data are useful for targeting state preventive health efforts.
UI - 12011131
AU - Grann VR; Jacobson JS; Thomason D; Hershman D; Heitjan DF; Neugut AI
TI - Effect of prevention strategies on survival and quality-adjusted survival of women with BRCA1/2 mutations: an updated decision analysis.
SO - J Clin Oncol 2002 May 15;20(10):2520-9
AD - Herbert Irving Comprehensive Cancer Center, Department of Medicine, College of Physicians and Surgeons, Columbia University, 630 W 168th Street, New York, NY 10032, USA.
PURPOSE: This study updates findings regarding the effects of prophylactic surgery, chemoprevention, and surveillance on the survival and quality-adjusted survival of women who test positive for BRCA1/2 mutations. MATERIALS AND METHODS: Markov modeling of outcomes was performed in a simulated cohort of 30-year-old women who tested positive for BRCA1/2 mutations. The model incorporated breast and ovarian cancer incidence rates from the literature and mortality rates from the Surveillance, Epidemiology, and End Results Program. Quality adjustment of survival estimates were obtained from a survey of women aged 33 to 50 years. Sensitivity analyses were performed of varied assumptions regarding timing and effects of preventive measures on cancer incidence and adverse effects. RESULTS: A 30-year-old woman could prolong her survival beyond that associated with surveillance alone by use of preventive measures: 1.8 years with tamoxifen, 2.6 years with prophylactic oophorectomy, 4.6 years with both tamoxifen and prophylactic oophorectomy, 3.5 years with prophylactic mastectomy, and 4.9 years with both surgeries. She could prolong her quality-adjusted survival by 2.8 years with tamoxifen, 4.4 years with prophylactic oophorectomy, 6.3 years with tamoxifen and oophorectomy, and 2.6 years with mastectomy, or with both surgeries. The benefits of all of these strategies would decrease if they were initiated at later ages. CONCLUSION: Women who test positive for BRCA1/2 mutations may derive greater survival and quality adjusted survival benefits than previously reported from chemoprevention, prophylactic surgery, or a combination. Observational studies and clinical trials are needed to verify the results of this analysis of the long-term benefits of preventive strategies among BRCA1/2-positive women.
UI - 12017906
AU - Diamant AL; Brook RH; Fink A; Gelberg L
TI - Use of preventive services in a population of very low-income women.
SO - J Health Care Poor Underserved 2002 May;13(2):151-63
AD - Division of General Medicine and Health Services Research, University of California, Los Angeles, USA.
UI - 11972383
AU - Brewster WR; Anton-Culver H; Ziogas A; Largent J; Howe S; Hubbell FA;
TI - Manetta A Recruitment strategies for cervical cancer prevention study.
SO - Gynecol Oncol 2002 May;85(2):250-4
AD - Epidemiology Division, Department of Medicine, University of California-Irvine, 224 Irvine Hall, Irvine, CA 92697-7550, USA. email@example.com
OBJECTIVE: The aim of this study was to describe recruitment strategies for a single-visit cervical cancer prevention study. METHODS: From were recruited to participate in a single-visit cervical cancer prevention study. For the first 6 months, all women who had ever visited one of two community-based study clinics were invited to participate (clinic registry recruitment). For the remainder of the year, recruitment was modified to be primarily inclusive of advertisements in English- and Spanish-language community newspapers and fliers left in local businesses and organizations (media campaign recruitment). Eligible volunteers were randomized to one of two study arms, usual-care program or single-visit program. All study subjects completed demographic and medical questionnaires delivered by bilingual staff. Women who declined to participate in this study were asked to provide reasons for this preference. Statistical analyses included the use of chi-square, logistic regression, and Student's t test. RESULTS: The proportion of women who agreed to participate was higher in the media recruitment group than in the clinic registry group [51% (535/1041) compared to 26% (405/1542), P < 0.001]. The no-show rate among participants solicited from the media strategy was significantly less than that from the clinic registry. There were no significant differences in the median age, number of months since the last Papanicolaou smear, incidence of abnormal Papanicolaou smear, education, or income of the subjects based on the recruitment strategy. CONCLUSION: A media-based recruitment strategy was effective for this single-visit cervical prevention study. This approach may be effective for recruitment of other low-income groups to clinical trials.
UI - 11972386
AU - Zou C; Vlastos AT; Yang L; Wang J; Nishioka K; Follen M
TI - Effects of difluoromethylornithine on growth inhibition and apoptosis in human cervical epithelial and cancerous cell lines.
SO - Gynecol Oncol 2002 May;85(2):266-73
AD - Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Texas Medical School at Houston, 1515 Holcombe Boulevard, Houston, TX 77030, USA.
OBJECTIVE: Difluoromethylornithine(DFMO), an irreversible inhibitor of ornithine decarboxylase and an angiogenesis inhibitor, has been used in phase I cervical intraepithelial neoplasia (CIN) trials, producing a 50% regression of CIN 3 lesions. DFMO is currently in phase II trials. In the experiments reported here, DFMO's growth inhibition and apoptosis induction were explored in an in vitro model to elucidate mechanisms of action. METHODS: Four immortalized cervical epithelial cell lines, serving as in vitro models of precancerous CIN lesions, and nine cervical carcinoma cell lines were studied. DFMO's growth inhibitory effect was tested in monolayer culture and in semisolid medium, and concentrations required for a 50% growth inhibition (IC(50)) with a 5-day treatment were determined. Apoptosis induction was analyzed using the terminal deoxynucleotidyl transferase assay of DNA fragmentation. RESULTS: DFMO inhibited growth of immortalized cervical epithelial cell lines and cervical cancer cell lines in monolayer culture and in semisolid medium. The immortalized cervical epithelial cell lines were more sensitive than the cervical cancer cell lines to DFMO's growth inhibitory effect. Concentrations required for 50% growth inhibition after a 5-day treatment ranged from 100 microM to >5 mM for cervical carcinoma cell lines and from 100 microM to 1 mM for immortalized cervical epithelial cell lines. DFMO induced apoptosis in precancerous and cancerous cell lines at a concentration of 5 mM, regardless of the cells' human papillomavirus status. CONCLUSION: DFMO inhibits the growth of cervical precancerous and cancerous cells in vitro in a dose-dependent and time-dependent manner, partially through inducing apoptosis. (c) 2002 Elsevier Science (USA).
UI - 11952753
AU - Herbert A; Johnson J
TI - Is it reality or an illusion that liquid-based cytology is better than conventional cervical smears? Authors' reply.
SO - Cytopathology 2002 Apr;13(2):133
UI - 11952745
AU - Moseley RP; Paget S
TI - Liquid-based cytology: is this the way forward for cervical screening?
SO - Cytopathology 2002 Apr;13(2):71-82
AD - The Pauline Cooper Department of Cytology, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ, UK. firstname.lastname@example.org
Liquid-based cytology (LBC) is currently being marketed as an alternative methodology to replace the conventional PAP smear in cervical cytology. A substantial body of literature exists in support of LBC, some of which is at least partially sponsored by product manufacturers. The majority of published literature in support of LBC employs Bethesda reporting terminology. In this study we have analysed published raw data and presented this in NHSCSP terminology. Claims relating to sensitivity, specificity and smear adequacy have then been considered with reference to this data. Our analysis of existing data does not support the nationwide implementation of LBC at present. Further studies are recommended in order to evaluate the place of this technology within the NHSCSP.
UI - 11979116
AU - Jenkins D
TI - Diagnosing human papillomaviruses: recent advances.
SO - Curr Opin Infect Dis 2001 Feb;14(1):53-62
AD - Division of Pathology, Faculty of Medicine and Health Sciences, University of Nottingham, Nottingham, UK. email@example.com
The biological importance of a group of human papillomaviruses, known as high-risk human papillomaviruses, as the key causal agent for almost all cervical cancer has now been established. Many aspects of the natural history of high-risk human papillomaviruses as sexually transmitted infections and as oncogenic agents have been researched. Although human papillomavirus diagnosis is largely confined to DNA detection techniques in cervical smears, there is accumulating evidence that the best polymerase chain reaction and hybrid capture techniques are more sensitive and probably of similar specificity compared with cervical cytology as a triage test for women with borderline smear abnormalities and for screening older women. This is strong presumptive evidence that high-risk human papillomavirus testing could be useful in cervical screening. Current research is aimed at establishing a place for high-risk human papillomavirus testing in routine screening practice. Randomised clinical trials, long-term natural history studies, mathematical modelling, and economic and psychosocial studies are being used to demonstrate whether this testing can improve both the effectiveness and efficiency of cervical screening in a range of situations.
UI - 11987569
AU - Sevcik L; Klat J; Koliba P
TI - [Hormone replacement therapy and ovarian tumors]
SO - Ceska Gynekol 2002 Mar;67(2):55-8
AD - Porodnicko-gynekologicka klinika, FNsP Ostrava.
OBJECTIVE: Analysis of risk and protective factors and hormone replacement therapy in the aethiology and pathogenesis of ovarian cancer. The role of hormone replacement therapy in the complex treatment in women with ovarian cancer is discussed. DESIGN: Reviewed article. SETTING: Department of Obstetrics and Gynaecology, University Hospital Ostrava. METHODS: Analysis of epidemiological studies. CONCLUSION: The role of hormone replacement therapy as a risk factor of ovarian cancer has not been confirmed. Hormone replacement therapy as a part of supportive and symptomatic therapy has been acceptable in a great deal of patients with ovarian cancer.
UI - 12015184
AU - Austin LT; Ahmad F; McNally MJ; Stewart DE
TI - Breast and cervical cancer screening in Hispanic women: a literature review using the health belief model.
SO - Womens Health Issues 2002 May-Jun;12(3):122-8
AD - University Health Network Women's Health Program, Toronto, Ontario, Canada.
The aim of this study was to review published studies that examined factors influencing breast and cervical cancer screening behavior in Hispanic women, using the Health Belief Model (HBM). MEDLINE and PsycINFO databases and manual search were used to identify articles. Cancer screening barriers common among Hispanic women include fear of cancer, fatalistic views on cancer, linguistic barriers, and culturally based embarrassment. In addition, Hispanic women commonly feel less susceptible to cancer, which is an important reason for their lack of screening. Positive cues to undergo screening include physician recommendation, community outreach programs with the use of Hispanic lay health leaders, Spanish print material, and use of culturally specific media. Critical review of the literature using the theoretical framework of the Health Belief Model identified several culturally specific factors influencing cancer screening uptake and compliance among Hispanic women. Future interventions need to be culturally sensitive and competent.
UI - 12015518
AU - Lindau ST; Tomori C; Lyons T; Langseth L; Bennett CL; Garcia P
TI - The association of health literacy with cervical cancer prevention knowledge and health behaviors in a multiethnic cohort of women.
SO - Am J Obstet Gynecol 2002 May;186(5):938-43
AD - Department of Obstetrics and Gynecology, Northwestern University Medical School, the University of Chicago Robert Wood Johnson Clinical Scholars Program, Ill 60637, USA.
OBJECTIVE: Our purpose was to describe the relationship between health literacy, ethnicity, and cervical cancer screening practices and to evaluate physician recognition of low literacy. STUDY DESIGN: We studied a prospective cohort of English-speaking patients > or =18 years (n = 529) in ambulatory women's clinics. Univariate and multivariate analyses were used to evaluate demographics, health practices and beliefs, and knowledge regarding cervical cancer screening and prevention. Physicians' assessments of patient reading skills were obtained. RESULTS: Low health literacy (<9th grade) was found among 40% of participants. Minority women were half as likely to know the purpose of the Papanicolaou test (9% vs 21%; P <.03) and were significantly more likely to have low literacy levels compared with white women (46% vs 15%; P <.05). Literacy was the only factor independently associated with knowledge related to cervical cancer screening (adjusted odds ratio, 2.25; 95% CI, 1.05-4.80). Physicians detected only 20% of the lowest readers. CONCLUSION: Poor health literacy was a better predictor of cervical cancer screening knowledge than ethnicity or education, yet physicians infrequently recognized low literacy. Improved physician awareness and development of low literacy interventions may improve cervical cancer screening, particularly for the most vulnerable women.
UI - 12015522
AU - Lorenzato FR; Singer A; Ho L; Santos LC; Batista Rde L; Lubambo TM;
TI - Terry G Human papillomavirus detection for cervical cancer prevention with polymerase chain reaction in self-collected samples.
SO - Am J Obstet Gynecol 2002 May;186(5):962-8
AD - Department of Obstetrics and Gynecology, Instituto Materno Infantil de Pernambuco, Brazil. firstname.lastname@example.org
OBJECTIVE: We studied the usefulness of self-sampling in cervical cancer prevention. STUDY DESIGN: A cross-sectional study was undertaken at screening services in Recife (Brazil); 253 women aged 16 to 88 years were included. Participants were randomly selected from a high-risk population for cervical neoplasia. All participants collected a self-sample with a cotton-tipped swab by rotating it against the vaginal epithelium and, possibly, the cervix. Physician-collected samples from the ectocervix and endocervix, respectively, with an Ayre's spatula and a Cytobrush endocervical brush (Medscand) were followed by thorough colposcopy. Human papillomaviruses were detected by consensus polymerase chain reaction and typed by restriction fragment length polymorphism. RESULTS: The difference among human papillomavirus results in samples that were self-collected versus physician collected was significant (P <.03). The agreements were poor among patients with cervical intraepithelial neoplasia (CIN) grade 3 (kappa <0.29) and cervical cancer (kappa < 0.10). Self-sampling missed 50% more cancers than did physician sampling (P =.04). CONCLUSION: Self-sampling with a cotton-tipped swab for human papillomavirus detection is not a safe method for the collection of samples that are aimed at primary cervical cancer screening.
UI - 11588063
AU - Sassi F; Le Grand J; Archard L
TI - Equity versus efficiency: a dilemma for the NHS. If the NHS is serious about equity it must offer guidance when principles conflict.
SO - BMJ 2001 Oct 6;323(7316):762-3
UI - 11813045
AU - Motta EV; Fonseca AM; Bagnoli VR; Ramos L; Pinotti JA
TI - [Colpocytology in a preventive gynecological ambulatory service]
SO - Rev Assoc Med Bras 2001 Oct-Dec;47(4):302-10
AD - Divisao de Ginecologia, Hospital das Clinicas, Faculdade de Medicina, Universidade de Sao Paulo.
BACKGROUND: evaluate the results of Pap smear in women attended at a gynecology preventive ambulatory (University of Sao Paulo Medical School Clinical Hospital). METHODS: 6821 women were submitted to a medical interview, clinical and gynecologic exam. Cervical and vaginal cytology (Pap smear) were analyzed according to the Papanicolaou method and classification. All women were grouped according to their age into three categories:under 40 years old, between 41 and 60 years and over 60 years. RESULTS: most of them, and mainly the younger ones, had been submitted to a previous Pap smear in a period shorter than 1 year (44.2%). The majority of women recognized the usefulness of the exam and knew its interval; the group that best knew its importance and interval was the one with ages between 41 and 60 years, while most women over 60 years did not know both its importance and interval. Cytological material was considered insufficient for analysis in 15,1% and inadequate in 1.1%, and for those with adequate material results were classes I (21.7%), II (59.9%), III (2.0%), IV (0.1%) and V (0.1%). Distribution of cervical intraepithelial neoplasia (CIN) were similar in the three groups. The main microbiologic findings was Gardnerella sp. (8,6%) and Human papillomavirus (HPV) incidence was significantly lower among women over 60 years. CONCLUSION: Cytological diagnoses of neoplastic modifications were performed in 2,2% and Gardnerella sp. was the most prevalent microbiologic agent. Distribution of HPV showed a decrease with age. Older women had lower knowledge on the importance of regular Pap smear examination.
UI - 11887236
AU - Nonnenmacher B; Breitenbach V; Villa LL; Prolla JC; Bozzetti MC
TI - [Genital human papillomavirus infection identification by molecular biology among asymptomatic women]
SO - Rev Saude Publica 2002 Feb;36(1):95-100
AD - Universidade Luterana do Brasil, Canoas, RS, Brasil. email@example.com
OBJECTIVE: To evaluate whether epidemiological factors may be associated to genital human papillomavirus (HPV) infection. METHODS: A cross-sectional study was carried out among 975 women seen at a public health service for cervical cancer screening in Porto Alegre, Brazil. Women were considered infected if tested positive to HPV either by Polymerase Chain Reaction (PCR) or Hybrid Capture II (HC-II) methods. Women with genital HPV infection were compared to women without infection drawn from the same population. RESULTS: The study enrolled 975 women. The HPV prevalence (both methods combined) in this population was 27%. However, when each diagnostic method is analyzed separately, HPV prevalence was 15% and 16% for HC-II and PCR, respectively. Unconditional multiple logistic regression was used to correlate disease status to women characteristics. A positive association was found with HPV infection for the following variables: years of schooling (11 years: OR=2.05; 95%CI =1.31; 3.20), married (OR=1.69; 95%CI=0.78; 2.00), number of lifetime sexual partners (2 partners: OR=1.67; 95%CI=1.01; 2.77; 4 or +: OR=2.18; 95%CI=1.15; 4.13), age at first intercourse (15-16 years: OR=4.05; 95%CI=0.89; 18.29). CONCLUSIONS: Various factors may contribute to genital HPV infection, especially those related to sexual behavior (young age at first intercourse, high number of lifetime sexual partners, and marital status), and those related to social and economic status (years of schooling).
UI - 11988136
AU - Dzuba IG; Diaz EY; Allen B; Leonard YF; Lazcano Ponce EC; Shah KV;
TI - Bishai D; Lorincz A; Ferris D; Turnbull B; Hernandez Avila M; Salmeron J The acceptability of self-collected samples for HPV testing vs. the pap test as alternatives in cervical cancer screening.
SO - J Womens Health Gend Based Med 2002 Apr;11(3):265-75
AD - The Johns Hopkins University School of Public Health, Baltimore, Maryland, USA.
OBJECTIVE: To explore the acceptability of the self-collection of samples for human papillomavirus (HPV) testing in comparison with that of the Pap test. METHODS: The study population consisted of 1069 women 20 years and older who were eligible for coverage through the Mexican Institute of Social Security (IMSS). These women were randomly selected among participants in a larger study to evaluate the use of HPV testing as an alternative in cervical cancer screening. All participants provided a self-collected vaginal sample for HPV testing according to explicit instructions and underwent a Pap test. Afterwards, each woman was interviewed about her experience and opinion regarding the two procedures. Acceptability was measured by a calculated score based on discomfort, pain, embarrassment, privacy, perception of personal treatment during the Pap test, and understanding of how to perform the self-sampling method. RESULTS: Ninety-three percent of women experienced sufficient privacy with the Pap test, whereas 98% of women reported that privacy with the self-sampling procedure was acceptable. The Pap test consistently provoked more discomfort, pain, and embarrassment than self-sampling. Sixty-eight percent of the women who indicated a test preference chose self-sampling. Preference for this method was positively associated with monthly household income. Women reported a preference for self-sampling because it is more comfortable (71.2%) and causes less embarrassment (55.8%). CONCLUSIONS: Self-sampling is more acceptable than the Pap test and could improve coverage rates of early detection programs. The incorporation of self-collected samples to detect HPV could encourage participation in screening programs among those women who reject the Pap test because of the necessary pelvic examination.
UI - 12039933
AU - Berry DA; Iversen ES Jr; Gudbjartsson DF; Hiller EH; Garber JE; Peshkin
TI - BN; Lerman C; Watson P; Lynch HT; Hilsenbeck SG; Rubinstein WS; Hughes KS; Parmigiani G BRCAPRO validation, sensitivity of genetic testing of BRCA1/BRCA2, and prevalence of other breast cancer susceptibility genes.
SO - J Clin Oncol 2002 Jun 1;20(11):2701-12
AD - Department of Biostatistics, University of Texas M.D. Anderson Cancer Center, Houston, TX 77030-4009, USA. firstname.lastname@example.org
PURPOSE: To compare genetic test results for deleterious mutations of BRCA1 and BRCA2 with estimated probabilities of carrying such mutations; to assess sensitivity of genetic testing; and to assess the relevance of other susceptibility genes in familial breast and ovarian cancer. PATIENTS AND METHODS: Data analyzed were from six high-risk genetic counseling clinics and concern individuals from families for which at least one member was tested for mutations at BRCA1 and BRCA2. Predictions of genetic predisposition to breast and ovarian cancer for 301 individuals were made using BRCAPRO, a statistical model and software using Mendelian genetics and Bayesian updating. Model predictions were compared with the results of genetic testing. RESULTS: Among the test individuals, 126 were Ashkenazi Jewish, three were male subjects, 243 had breast cancer, 49 had ovarian cancer, 34 were unaffected, and 139 tested positive for BRCA1 mutations and 29 for BRCA2 mutations. BRCAPRO performed well: for the 150 probands with the smallest BRCAPRO carrier probabilities (average, 29.0%), the proportion testing positive was 32.7%; for the 151 probands with the largest carrier probabilities (average, 95.2%), 78.8% tested positive. Genetic testing sensitivity was estimated to be at least 85%, with false-negatives including mutations of susceptibility genes heretofore unknown. CONCLUSION: BRCAPRO is an accurate counseling tool for determining the probability of carrying mutations of BRCA1 and BRCA2. Genetic testing for BRCA1 and BRCA2 is highly sensitive, missing an estimated 15% of mutations. In the populations studied, breast cancer susceptibility genes other than BRCA1 and BRCA2 either do not exist, are rare, or are associated with low disease penetrance.
UI - 12040639
AU - Belinson JL; Pan QJ; Biscotti C; Wu LY; Pretorius RG; Li L; Elson P;
TI - Rong SD; Zhang WH; Qiao YL Primary screening with liquid-based cytology in an unscreened population in rural China, with an emphasis on reprocessing unsatisfactory samples.
SO - Acta Cytol 2002 May-Jun;46(3):470-4
AD - Section of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cleveland Clinic Foundation, 9500 Euclid Avenue, A-81, Cleveland, Ohio 44195, USA.
OBJECTIVE: To determine the sensitivity and specificity of liquid-based cytology in a high-risk, unscreened population. STUDY DESIGN: A cross-sectional comparative trial of multiple screening techniques. This report focuses on the performance of liquid-based cytology using biopsy as the standard. RESULTS: In total, 1,997 women were screened. All subjects had a minimum of five cervical biopsies. Of the subjects, 4.3% had CIN 2 on biopsy. The ThinPrep Pap with ASCUS as positive had a sensitivity for CIN 2 of 94% and specificity of 78%; the sensitivity for CIN 3 was 98% and for cancer, 100%. The unsatisfactory rate due to bloody specimens was 7.9% (158/1,997). After reprocessing, the unsatisfactory rate was 0.15% (3/1,997). CONCLUSION: Reprocessing effectively recovers ThinPrep samples otherwise unsatisfactory due to blood and mucus. The ThinPrep Pap test is a highly sensitive screening test when used in a high-risk, unscreened population.
UI - 11937318
AU - Bos AB; van Ballegooijen M; van Oortmarssen GJ; Habbema JD
TI - Women who participate in spontaneous screening are not at higher risk for cervical cancer than women who attend programme screening.
SO - Eur J Cancer 2002 Apr;38(6):827-31
AD - Department of Public Health, Faculty of Medicine, Erasmus University Rotterdam, PO Box 1738, 3000 DR, The Netherlands. email@example.com
Up to 1995, programme screening for cervical cancer in The Netherlands was targeted at women between 35 and 54 years of age at 3-yearly intervals. Spontaneous screening in addition to programme screening was common practice. Our aim was to compare the underlying risk for cervical neoplasia for women involved in both types of screening. From the national pathological database, we retrieved all primary smears (n=693318) taken in 1994 in The Netherlands. Among the smears registered for screening purposes (39%), 79% was taken within the mass screening programme and 21% was taken for spontaneous screening. The underlying risk was studied from the detection rates of histologically confirmed severe dysplasia or worse, using a multivariate loglinear model, including age and screening history. The detection rate of at least severe dysplasia, adjusted for age and screening history, was equal for women who had a spontaneous smear and for those who had a programme smear (odds ratio (OR): 0.97; 95% Confidence Interval (CI): 0.84-1.14). In our data, women participating in spontaneous screening were not at a higher risk for cervical cancer than women who used programme screening. Therefore, all asymptomatic women in the Netherlands should follow the general guidelines for age-range and screening-interval.
The above citations and abstracts reflect those newly added to CANCERLIT for the month and topic listed in the title. The citations have been retrieved from CANCERLIT using a predefined search strategy of indexed subject terms. Although the search strategy has been refined as best as possible, citations may appear that are not directly related to the topic, and occasionally relevant references may be omitted.