Patterns of cervical cancer screening follow-up in the era of prolonged screening intervals.

Gynecol Oncol

Columbia University College of Physicians and Surgeons, USA; Herbert Irving Comprehensive Cancer Center, USA; New York Presbyterian Hospital, USA. Electronic address:

Published: August 2023

Introduction: Little is known as to how prolonged screening recommendations for cervical cancer have affected compliance.

Objective: We examined compliance with repeat cervical cancer screening among U.S. women aged 30-64 who underwent index screening between 2013 and 2019.

Study Design: The IBM Watson Health MarketScan Database was used to identify commercially-insured women 30-64 years old who underwent cervical cancer screening from 2013 to 2019. The cohort was limited to women with continuous insurance 12 months before and ≥ 2 months after index testing. Patients with prior hysterectomy, more frequent surveillance needs, or a history of abnormal cytology, histology, or HPV test were excluded. Index screening included cytology, co-testing, or primary HPV testing. Cumulative incidence curves described screening intervals. Compliance was considered if repeat screening occurred 2.5-4 years after index cytology and 4.5-6 years after index co-testing. Cause-specific hazard models examined factors associated with compliance.

Results: Of 5,368,713 patients identified, co-testing was performed in 2,873,070 (53.5%), cytology in 2,422,480 (45.1%), and primary HPV testing in 73,163 (1.4%). The cumulative incidence of repeat screening among all women by seven years was 81.9%. Of those who underwent repeat screening, 85.7% with index cytology and 96.6% with index co-testing were rescreened early. Only, 12.2% with index cytology had appropriate rescreening and 2.1% had delayed rescreening. Among the index co-testing group, 3.2% had appropriate rescreening and 0.3% had delayed rescreening.

Conclusion: Appropriate cervical cancer follow-up screening is highly variable. The cumulative incidence rate of repeat screening was 81.9% and among women rescreened, the vast majority are tested earlier than recommended by current guidelines.

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.ygyno.2023.06.007DOI Listing

Publication Analysis

Top Keywords

cervical cancer
20
repeat screening
16
screening
13
cancer screening
12
cumulative incidence
12
prolonged screening
8
screening intervals
8
screening women
8
screening 2013
8
primary hpv
8

Similar Publications

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!