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Cervical Cancer Screening Intervals Preferred by U.S. Women.

ABSTRACT: INTRODUCTION:Many U.S. women continue to be screened annually for cervical cancer, despite current guidelines that recommend 3- or 5-year screening intervals depending on screening modality and patient age. METHODS:Data from 2012 and 2015 web-based surveys of U.S. adults were analyzed in 2017 to investigate U.S. women's cervical cancer screening preferences. The study was limited to women aged ?18 years without a hysterectomy or cervical cancer diagnosis (2012 n=1,380, 2015 n=1,339). RESULTS:Women's preference for 3- or 5-year screening intervals doubled during the study period (2012: 31.2%, 2015: 64.2%, p<0.001). The most preferred screening options in 2015 were co-testing every 3 years with the Pap and human papillomavirus tests (34.0%) and annual Pap testing (30.4%)-neither of which were recommended at that time or currently. Use of 3- and 5-year Pap testing intervals increased during the study period (2012: 6.9%, 2015: 12.9%, p<0.001), whereas annual Pap testing declined (2012: 48.5%, 2015: 35.6%, p<0.001). Among women who were regularly screened and preferred 3- or 5-year screening intervals, the minority reported screening practices that matched this preference (2012: 24.1%, 2015: 29.3%, p=0.71). CONCLUSIONS:Women's preference for longer cervical cancer screening intervals has increased rapidly and outpaced utilization. At the same time, many women continue to be screened annually. Expanding appropriate screening may require increasing women's and providers' comfort with screening recommendations.

SUBMITTER: Cooper CP

PROVIDER: S-EPMC6102077 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Cervical Cancer Screening Intervals Preferred by U.S. Women.

Cooper Crystale Purvis CP Saraiya Mona M

American journal of preventive medicine 20180720 3

<h4>Introduction</h4>Many U.S. women continue to be screened annually for cervical cancer, despite current guidelines that recommend 3- or 5-year screening intervals depending on screening modality and patient age.<h4>Methods</h4>Data from 2012 and 2015 web-based surveys of U.S. adults were analyzed in 2017 to investigate U.S. women's cervical cancer screening preferences. The study was limited to women aged ≥18 years without a hysterectomy or cervical cancer diagnosis (2012 n=1,380, 2015 n=1,33 ...[more]

PMID: 30033024

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Project description:OBJECTIVE:We suggested cervical cancer screening strategies for women living with HIV (WLHIV) by comparing their precancer risks to general population women, and then compared our suggestions with current Centers for Disease Control and Prevention (CDC) guidelines. DESIGN:We compared risks of biopsy-confirmed cervical high-grade squamous intraepithelial neoplasia or worse (bHSIL+), calculated among WLHIV in the Women's Interagency HIV Study, to 'risk benchmarks' for specific management strategies in the general population. METHODS:We applied parametric survival models among 2423 WLHIV with negative or atypical squamous cell of undetermined significance (ASC-US) cytology during 2000-2015. Separately, we synthesized published general population bHSIL+ risks to generate 3-year risk benchmarks for a 3-year return (after negative cytology, i.e. 'rescreening threshold'), a 6-12-month return (after ASC-US), and immediate colposcopy [after low-grade squamous intraepithelial lesion (LSIL)]. RESULTS:Average 3-year bHSIL+ risks among general population women ('risk benchmarks') were 0.69% for a 3-year return (after negative cytology), 8.8% for a 6-12-month return (after ASC-US), and 14.4% for colposcopy (after LSIL). Most CDC guidelines for WLHIV were supported by comparing risks in WLHIV to these benchmarks, including a 3-year return with CD4 greater than 500 cells/?l and after either three negative cytology tests or a negative cytology/oncogenic human papillomavirus cotest (all 3-year risks?1.3%); a 1-year return after negative cytology with either positive oncogenic human papillomavirus cotest (1-year risk?=?1.0%) or CD4 cell count less than 500 cells/?l (1-year risk?=?1.1%); and a 6-12-month return after ASC-US (3-year risk?=?8.2% if CD4 cell count at least 500 cells/?l; 10.4% if CD4 cell count?=?350-499 cells/?l). Other suggestions differed modestly from current guidelines, including colposcopy (vs. 6-12 month return) for WLHIV with ASC-US and CD4 cell count less than 350 cells/?l (3-year risk?=?16.4%) and a lengthened 2-year (vs. 1-year) interval after negative cytology with CD4 cell count at least 500 cells/?l (2-year risk?=?0.98%). CONCLUSIONS:Current cervical cancer screening guidelines for WLHIV are largely appropriate. CD4 cell count may inform risk-tailored strategies.

Dataset Information

Cervical Cancer Screening Intervals Preferred by U.S. Women.

Publications

Cervical Cancer Screening Intervals Preferred by U.S. Women.

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