A state-wide population-based evaluation of cervical cancers arising during opportunistic screening in the United States
| Autor: | Rebecca Landy, Christopher Mathews, Michael Robertson, Charles L. Wiggins, Yolanda J. McDonald, Daniel W. Goldberg, Isabel C. Scarinci, Jack Cuzick, Peter D. Sasieni, Cosette M. Wheeler, Nancy E. Joste, Walter Kinney, Ruth M. McDonald, Alan Waxman, Steven Jenison, Philip E. Castle, Vicki Benard, Debbie Saslow, Jane J. Kim, Mark H. Stoler, Giovanna Rossi, Kevin English |
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| Rok vydání: | 2020 |
| Předmět: |
Adult
0301 basic medicine medicine.medical_specialty Screening test New Mexico Uterine Cervical Neoplasms Population based Adenocarcinoma Article 03 medical and health sciences 0302 clinical medicine Biopsy Humans Mass Screening Medicine Registries Case series False Negative Reactions Opportunistic screening Early Detection of Cancer Human papillomavirus (HPV) Cervical cancer Cervical screening medicine.diagnostic_test business.industry Obstetrics Obstetrics and Gynecology Cancer Middle Aged medicine.disease 030104 developmental biology Oncology 030220 oncology & carcinogenesis Screening Carcinoma Squamous Cell Female Cytology business Cervical cancer incidence |
| Zdroj: | Gynecologic Oncology |
| ISSN: | 0090-8258 |
| Popis: | Objective Despite widespread cervical screening, an estimated 13,800 women will be diagnosed with cervical cancer in the United States in 2020. To inform improvements, the screening histories of women diagnosed with cervical cancer in New Mexico were assessed. Methods Data were collected on all cervical screening, diagnostic tests and treatment procedures for all women diagnosed with cervical cancer aged 25-64 yrs. in New Mexico from 2006 to 2016. Women were categorized by their screening attendance in the 5–40 months (screening interval) and 1–4 months (peri-diagnostic interval) prior to cancer diagnosis. Results Of the 504 women diagnosed between May 2009–December 2016, 64% were not screened or had only inadequate screening tests in the 5–40 months prior to diagnosis, and 90 of 182 screened women (49%) had only negative screens in this period. Only 32% (N = 162) of cervical cancers were screen-detected. Women with adenocarcinomas were more likely to have had a recent negative screen (41/57 = 722%) than women with squamous cancers (50/112 = 45%). Both older women (aged 45–64 years) and women with more advanced cancers were less likely to have been screened, and if screened, were more likely to have a false-negative outcome. Only 9% of cancers were diagnosed in women who did not attend biopsy or treatment after positive tests requiring clinical management. Screening currently prevents 35% of cancers, whereas full screening coverage could prevent 61% of cervical cancers. Conclusion Improved screening coverage has the largest potential for reducing cervical cancer incidence, though there is also a role for improved recall procedures and screening sensitivity. Highlights • 64% of women diagnosed with cervical cancer aged 25-64y had not been screened in the 3-years prior to diagnosis. • Screening currently prevents 35% of cancers; full screening coverage could prevent 61% of cancers. • One-third of cervical cancers were screen-detected (i.e. diagnosed within 4 months of a positive screen). • 72% of the adenocarcinomas had a negative screen in a 3-yr period prior to diagnosis. • 9% of cancers were associated with a failure to receive recommended diagnostic biopsy or treatment (failsafe failure). |
| Databáze: | OpenAIRE |
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