Clinical follow-up practices after cervical cancer screening by co-testing: A population-based study of adherence to U.S. guideline recommendations.
Cervical câncer screening
Clinical practice
Co-testing
Cotesting follow-up
Journal
Preventive medicine
ISSN: 1096-0260
Titre abrégé: Prev Med
Pays: United States
ID NLM: 0322116
Informations de publication
Date de publication:
12 2021
12 2021
Historique:
received:
15
03
2021
revised:
07
07
2021
accepted:
15
08
2021
pubmed:
21
8
2021
medline:
22
3
2022
entrez:
20
8
2021
Statut:
ppublish
Résumé
Failure to follow-up women after abnormal cervical screening could lead to cervical cancers, yet little is known about adherence to recommended follow-up after abnormal co-testing [cytology and high-risk human papillomavirus (hrHPV) testing]. We documented clinical management following cervical screening by co-testing in a diverse population-based setting. A statewide surveillance program for cervical screening, diagnosis, and treatment was used to investigate all cytology, hrHPV and biopsy reports in the state of New Mexico from January 2015 through August 2019. Guideline-adherent follow-up after co-testing required 1) biopsy within 6 months for low-grade cytology if positive for hrHPV, for high-grade cytology irrespective of hrHPV, and for HPV 16/18 positive results irrespective of cytology and; 2) repeat co-testing within 18 months if cytology was negative and hrHPV test was positive (excluding types 16/18). Screening co-tests (2015-2017) for 164,522 women were analyzed using descriptive statistics, Kaplan Meier curves, and pairwise comparisons between groups. Guideline adherence was highest when both cytology and hrHPV tests were abnormal, ranging from 61.7% to 80.3%. Guideline-adherent follow-up was lower for discordant results. Women with high-grade cytology were less likely to receive a timely biopsy when hrHPV-testing was negative (48.1%) versus positive (83.3%) (p < 0.001). Only 47.9% of women received biopsies following detection of HPV16/18 with normal cytology, and 30.8% received no follow-up within 18-months. Among women with hrHPV-positive normal cytology without evidence of HPV 16/18 infection, 51% received no follow-up within 18 months. Provider education and creation of robust recall systems may help ensure appropriate follow-up of abnormal screening results.
Identifiants
pubmed: 34416221
pii: S0091-7435(21)00339-X
doi: 10.1016/j.ypmed.2021.106770
pmc: PMC8595756
mid: NIHMS1737045
pii:
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
106770Subventions
Organisme : NCI NIH HHS
ID : P30 CA118100
Pays : United States
Organisme : NIAID NIH HHS
ID : U19 AI113187
Pays : United States
Investigateurs
Nancy E Joste
(NE)
Walter Kinney
(W)
Cosette M Wheeler
(CM)
Charles Wiggins
(C)
Michael Robertson
(M)
Ruth McDonald
(R)
Alan Waxman
(A)
Steven Jenison
(S)
Philip E Castle
(PE)
Vicki Benard
(V)
Stephanie C Melkonian
(SC)
Jean Howe
(J)
Debbie Saslow
(D)
Jane J Kim
(JJ)
Mark H Stoler
(MH)
Jack Cuzick
(J)
Rebecca B Perkins
(RB)
Janice L Gonzales
(JL)
Salina Torres
(S)
Giovanna Rossi
(G)
Kevin English
(K)
Informations de copyright
Copyright © 2021 The Authors. Published by Elsevier Inc. All rights reserved.
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