Page 26 - Screening for Cervical Cancer: Systematic Evidence Review

Chapter I. Introduction

required a narrow focus. Ultimately we concurred that our work would be best focused on the

screening needs of older women and on screening after hysterectomy. As a result, we restricted

our examination to the evidence about the cervical cancer screening needs of older women who

have had a hysterectomy.

Specifically, we asked what are the outcomes (benefits, harms, and costs) associated with

screening:

1A. Among women age 65 and older?

1B. Among women who have had a hysterectomy?

Only Key Question 1A is focused on older age, interval among older women, and

screening outcomes. The remainder of the entire SER applies to all women irrespective of age.

For instance, 1B addresses screening among all women who have had a hysterectomy.

Key Question 2: To what extent do new methods for preparing or evaluating cervical

cytology improve diagnostic yield compared to conventional methods? At what cost

(harms and economic)?

Key Question 3: What is the role of HPV testing in cervical cancer screening

strategies? Specifically:

3A. What are the benefits, harms, and costs of using HPV testing as a screening
test, or of incorporating HPV testing at the time of the screening Pap test,
compared with not testing for HPV?

3B. What are the benefits, harms, and costs of using HPV testing as part of a
screening strategy to determine which women with an abnormal Pap test should
receive further evaluation?

Relevant Outcomes

Incidence of cervical cancer, severity of disease at the time of diagnosis, and cervical

cancer mortality are relevant to all questions. However, no trials have been conducted to

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