Cervical Cancer Screening Clinical Practice Guidelines in Oncology

2004 ◽  
Vol 2 (6) ◽  
pp. 570 ◽  

Despite a significant decrease in the incidence and mortality of cervical carcinoma in the United States, 10,520 women are expected to develop the disease in 2004, with 3,900 expected deaths. Because cervical cytology screening is the current method for early detection of this neoplasm, the purpose of the NCCN Cervical Cancer Screening Guidelines is to provide direction for the evaluation and management of cervical cytology. For the most recent version of the guidelines, please visit NCCN.org

2008 ◽  
Vol 6 (1) ◽  
pp. 58 ◽  
Author(s):  
_ _

Cervical carcinoma remains a health issue for women worldwide. Cervical cytology screening is the current method for early detection, and the NCCN Cervical Cancer Screening Clinical Practice Guidelines in Oncology provide direction for evaluating and managing this process, including clarified and revised recommendations on screening techniques and intervals and follow-up of abnormal screening results, including colposcopy. Human papillomavirus (HPV) DNA testing for primary cervical cancer has been approved by the FDA, and HPV DNA testing for high-risk virus types can also be used as a component of both primary screening and workup of abnormal cytology results. Colposcopy, along with colposcopically directed biopsies, has become the primary method for evaluating women with abnormal cervical cytologies. Special considerations for colposcopy performed during pregnancy are also discussed. For the most recent version of the guidelines, please visit NCCN.org


2018 ◽  
Vol 142 (6) ◽  
pp. 688-692 ◽  
Author(s):  
Melina B. Flanagan

Context.— The most recent update to cervical cancer screening guidelines offers interim guidance on the use of primary human papillomavirus (HPV) screening, with algorithms for management of results. After decades of screening with pure cytology and a shorter time with adjunctive HPV or cotesting with Papanicolaou (Pap) test and HPV, this is a significant change to our screening methods. Objective.— To briefly review the history of cervical cancer screening, the evidence upon which these interim guidelines were based, the arguments for and against primary HPV testing, and the current state of the field. Data Sources.— Primary studies, review articles, and commentaries were reviewed. Conclusions.— While there is evidence both for and against primary HPV testing, there are a growing number of countries adopting the practice. It would be worthwhile to be informed and prepared for such a change in the United States as well.


Author(s):  
James C. Quon

Background: 2017 US Preventive Services Task Force guidelines for screening cervical cancer and pre-malignant lesions advise that screenings cease for women over age 65, with qualifications. Recent literature has identified significant discrepancies in rates of cervical cancer in older women – if hysterectomies in this patient population is accounted for, cervical cancer incidence does not decline with age as previously established. This adjusted incidence of cervical cancer necessitates a re-examination of current practice.Methods: This study seeks to demonstrate the utility of extending the cervical cancer screening age recommendations to age 70. Cost effectiveness will be estimated, from a payer perspective, of extending screening to age 70 for the United States women’s population in those who have not undergone hysterectomy or otherwise been treated for past cervical cancer or premalignancy. A Markov model was constructed to project outcomes in a hypothetical cohort of 10 000 women aged 65 to 70, with a time horizon of lifetime. A Probability Sensitivity Analysis determined the robustness of the result, and the Incremental Cost-effectiveness Ratio (ICER) is charted.Results: The economic evaluation of screening compared to none in this population was determined to be cost effective, with an ICER demonstrating a cost benefit, and Quality Adjusted Life Year (QALY) benefit, to extended screening.Conclusions: The sensitivity analysis confirms the robustness of this result. Implementing extended screening guidelines could potentially be a significant gain for both patients and society.


2021 ◽  
Author(s):  
Jiyeong Kim ◽  
Melanie Dove ◽  
Julie HT Dang

Abstract Background. Family caregivers may be at a higher risk for several chronic diseases including cancer. Cervical cancer is one of the most prevalent cancers among U.S. women. Despite family caregivers’ vulnerability, the status of their HPV awareness, knowledge, and preventive health behaviors, including cervical cancer screening, have been understudied. Thus, this study aimed to examine the sociodemographic factors associated with HPV awareness and knowledge, and adherence to the cervical cancer screening guidelines among caregivers in the U.S. Methods. Nationally representative cross-sectional survey data were obtained from the Health Information National Trends Survey (HINTS 5, 2017-2020). Only female caregivers, aged 21-65, were included (N= 834). Weighted multivariate logistic regression was performed to identify factors associated with HPV awareness, knowledge, and adherence to the United States Preventive Service Task Force cervical cancer screening guidelines (by age, race/ethnicity, education, household income, marital status, employment status, and health insurance type). Results. Caregivers who were older (aged 51-65 vs. 21-50), were less educated (high school graduate or less vs. some college or more) showed lower adherence to the cervical cancer screening guidelines (every 3 years) than their counterparts. Caregivers who were older and less educated showed lower HPV awareness (Heard of HPV).Conclusions. There are caregiving populations whose HPV awareness, knowledge and cervical cancer screening adherence are low. To improve their awareness and knowledge of HPV and support their cervical cancer screening behaviors, we need to consider interventions that target those specific populations.


2021 ◽  
Vol 13 ◽  
pp. 175883592110109
Author(s):  
Binhua Dong ◽  
Huachun Zou ◽  
Xiaodan Mao ◽  
Yingying Su ◽  
Hangjing Gao ◽  
...  

Background: China’s Fujian Cervical Pilot Project (FCPP) transitioned cervical cancer screening from high-risk human papillomavirus (HR-HPV) nongenotyping to genotyping. We investigated the clinical impact of this introduction, comparing performance indicators between HR-HPV genotyping combined with cytology screening (HR-HPV genotyping period) and the previous HR-HPV nongenotyping combined with cytology screening (HR-HPV nongenotyping period). Methods: A retrospective population-based cohort study was performed using data from the FCPP for China. We obtained data for the HR-HPV nongenotyping period from 1 January 2012 to 31 December 2013, and for the HR-HPV genotyping period from 1 January 2014 to 31 December 2016. Propensity score matching was used to match women from the two periods. Multivariable Cox regression was used to assess factors associated with cervical intraepithelial neoplasia of grade 2 or worse (CIN2+). The primary outcome was the incidence of CIN2+ in women aged ⩾25 years. Performance was assessed and included consistency, reach, effectiveness, adoption, implementation and cost. Results: Compared with HR-HPV nongenotyping period, in the HR-HPV genotyping period, more CIN2+ cases were identified at the initial screening (3.06% versus 2.32%; p < 0.001); the rate of colposcopy referral was higher (10.87% versus 6.64%; p < 0.001); and the hazard ratio of CIN2+ diagnosis was 1.64 (95% confidence interval, 1.43–1.88; p < 0.001) after controlling for health insurance status and age. The total costs of the first round of screening (US$66,609 versus US$65,226; p = 0.293) were similar during the two periods. Higher screening coverage (25.95% versus 25.19%; p = 0.007), higher compliance with age recommendations (92.70% versus 91.69%; p = 0.001), lower over-screening (4.92% versus 10.15%; p < 0.001), and reduced unqualified samples (cytology: 1.48% versus 1.73%, p = 0.099; HR-HPV: 0.57% versus 1.34%, p < 0.001) were observed in the HR-HPV genotyping period. Conclusions: Introduction of an HR-HPV genotyping assay in China could detect more CIN2+ lesions at earlier stages and improve programmatic indicators. Evidence suggests that the introduction of HR-HPV genotyping is likely to accelerate the elimination of cervical cancer in China.


2016 ◽  
Author(s):  
Astha Srivastava ◽  
Bindiya Gupta ◽  
Vikas Lakha ◽  
Shilpa Singh

Objective: To study the knowledge, attitude and practice of nurses at tertiary centre regarding cervical cancer screening. Material and Methods: Validated questionnaire was circulated amongst staff nurses at tertiary care centre after taking informed consent. Results and Discussion: Cancer of cervix is the most common genital tract malignancy in female and it is ranked second to breast cancer. It has a positive association with HPV infection. Cervical cancer incidence and mortality have declined substantially following introduction of screening programmes. This present study investigated the knowledge, attitude and practice of nurses at GTB Hospital towards cervical cancer risk factors, sign & symptoms and screening as they are important health professionals. In our study, the results showed that 99% of respondents were aware of Pap smear as screening programme and about 60-70% were aware of HPV as positive organism, but most of them never had a Pap smear done before. Majority of them did not know VIA, VILI and colposcopy as screening techniques. Conclusion: It may thus be recommended that institutions should periodically organize seminars and training for health personnel especially the nurses which form a group of professionals that should give health education to women about cervical cancer.


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