Page 111 - Screening for Cervical Cancer: Systematic Evidence Review

Appendix C. Evidence Tables

Evidence Table 1A. Screening Among Older Women (cont'd)

Screening Outcomes & Quality
Participants Program Measures Relevant Results Considerations
N = not defined National Primary INTERVAL: Denom=2
screening outcome = Attrition=1
(only rates program with histologically Cumulative rate of histologically Indications=1
given) call and recall proven lesions verified lesions among women Interval=2
of ages 25-69 referred for colposcopy rises from Age=2
(1970-1987) Secondary 10% of those referred within 2 yrs of Relevance=1
now 20-69 outcome = a normal Pap to 70% of those Standard=2
(began 1988) moderate to referred within 5 yrs. Score=11
for screening high grade
q2-3 years smears AGE: Grade=Fair
After age 60, the rate of moderate to
high-grade dysplasia among women
without prior screening = 16/1000;
5.7/1000 if 1-4 prior screens; 2.8 if
≥ 5

N = 128,805 Primary AGE: Denom=2
women with outcome = high Attrition=2
initial normal grade SIL or 2nd screening results Indications=1
Pap and another worse on LSIL HSIL SCCA Interval=2
within 36 cytology (%) (%) (%) Age=2
months < 30 389 (3.2) 80 (0.7) 1 (0.01) Relevance=2
30-49 523 (1.0) 111 (0.2) 5 (0.01)
Secondary 50-64 186 (0.4) 67 (0.14) 4 (0.01) Standard=0
(excludes those outcome = ≥ 65 42 (0.3) 13 (0.08) 3 (0.02) Score=11
with glandular other cytologic
cell abnormality INTERVAL: Grade=Fair
abnormalities) Age-adjusted incidence per 10,000
Second smears women
Age results: (%)
<30 9.5% Benign 94.4 Time from
normal ASCUS LSIL HSIL +
30-49 41.6% ASCUS 3.4 9-12 mos 377 107 25
50-64 36.8% LSIL 0.9 13-24 373 125 29
≥ 65 12.1% HSIL 0.2 25-36 415 141 33
Cancer 0.0 P (trend) 0.36 0.01 0.42
White 57.2%
Black, non-Hisp
13.4%
Hisp 17.6%
Asian 2.4%
AmInd 8.5%

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