OBJECTIVE: To describe results of cervical cytology screening among low-income and uninsured women in the National Breast and Cervical Cancer Early Detection Program. METHODS: We analyzed data from 750,591 women who r...OBJECTIVE: To describe results of cervical cytology screening among low-income and uninsured women in the National Breast and Cervical Cancer Early Detection Program. METHODS: We analyzed data from 750,591 women who received their first Papanicoiaou (Pap) test in the program between July 1995 and March 2001. RESULTS: Nearly 85%of the women were aged 40 years or older. Almost half were members of racial or ethnic minority groups. Overall, the percentage of abnormal Pap test results decreased with increasing age. The rates of cervical intraepithelial neoplasia (CIN) were highest in the younger age groups but the rate of invasive cancer increased with age. White women had the highest age-adjusted percentage of abnormal Pap test results and the highest rate of biopsy-confirmed CIN 2 or worse. CONCLUSIONS: In this nationwide screening program, only 7%of all biopsy-confirmed high-grade cervical lesions (CIN 2 or worse) were invasive cancer. This underscores the success of Pap screening in identifying preinvasive disease and preventing cancer.展开更多
OBJECTIVE: To determine whether women in the National Breast and Cervical Ca nc er Early Detection Program (NBCCEDP) who had findings on a Papanicolaou (Pap) te st of atypical squamous cells of undetermined significan...OBJECTIVE: To determine whether women in the National Breast and Cervical Ca nc er Early Detection Program (NBCCEDP) who had findings on a Papanicolaou (Pap) te st of atypical squamous cells of undetermined significance (ASC-US) or low-gra de squamous intraepithelial lesions (LSIL) were followed up in accordance with t he interim guidelines for management of abnormal cervical cytology. METHODS: For this study period, the guidelines for a Pap result of ASC-US or LSIL specified follow-up by Pap tests repeated every 4 to 6 months for 2 years. If a second r eport of ASC-US or LSIL was made, the patient was to have colposcopy. We analyz ed data from 10,004 women who had a result of ASC-US or LSIL followed by a seco nd ASC-US or LSIL from 1991-2000. RESULTS: As judged by the guidelines, 44%of women who had 2 low-grade abnormalities were followed up appropriately with co lposcopy. Among women with 2 ASC-US results, those aged less than 30 years were more likely to receive colposcopy than the other age groups, while women who we re aged 60 years and olde r were more likely to be followed up with a third Pap test. For each of the 4 re sult groups, American Indian or Alaska Native women had the highest percentages of a third Pap test, whereas Black or African-American women had a higher perce ntage of no follow-up. CONCLUSION: More than one half of the women studied were not followed up in accordance with the established guidelines for managing abno rmal cervical cytology. Factors such as age and race or ethnicity influence whet her women with cytologic abnormalities receive appropriate follow-up.展开更多
文摘OBJECTIVE: To describe results of cervical cytology screening among low-income and uninsured women in the National Breast and Cervical Cancer Early Detection Program. METHODS: We analyzed data from 750,591 women who received their first Papanicoiaou (Pap) test in the program between July 1995 and March 2001. RESULTS: Nearly 85%of the women were aged 40 years or older. Almost half were members of racial or ethnic minority groups. Overall, the percentage of abnormal Pap test results decreased with increasing age. The rates of cervical intraepithelial neoplasia (CIN) were highest in the younger age groups but the rate of invasive cancer increased with age. White women had the highest age-adjusted percentage of abnormal Pap test results and the highest rate of biopsy-confirmed CIN 2 or worse. CONCLUSIONS: In this nationwide screening program, only 7%of all biopsy-confirmed high-grade cervical lesions (CIN 2 or worse) were invasive cancer. This underscores the success of Pap screening in identifying preinvasive disease and preventing cancer.
文摘OBJECTIVE: To determine whether women in the National Breast and Cervical Ca nc er Early Detection Program (NBCCEDP) who had findings on a Papanicolaou (Pap) te st of atypical squamous cells of undetermined significance (ASC-US) or low-gra de squamous intraepithelial lesions (LSIL) were followed up in accordance with t he interim guidelines for management of abnormal cervical cytology. METHODS: For this study period, the guidelines for a Pap result of ASC-US or LSIL specified follow-up by Pap tests repeated every 4 to 6 months for 2 years. If a second r eport of ASC-US or LSIL was made, the patient was to have colposcopy. We analyz ed data from 10,004 women who had a result of ASC-US or LSIL followed by a seco nd ASC-US or LSIL from 1991-2000. RESULTS: As judged by the guidelines, 44%of women who had 2 low-grade abnormalities were followed up appropriately with co lposcopy. Among women with 2 ASC-US results, those aged less than 30 years were more likely to receive colposcopy than the other age groups, while women who we re aged 60 years and olde r were more likely to be followed up with a third Pap test. For each of the 4 re sult groups, American Indian or Alaska Native women had the highest percentages of a third Pap test, whereas Black or African-American women had a higher perce ntage of no follow-up. CONCLUSION: More than one half of the women studied were not followed up in accordance with the established guidelines for managing abno rmal cervical cytology. Factors such as age and race or ethnicity influence whet her women with cytologic abnormalities receive appropriate follow-up.
