Page 39 - Screening for Cervical Cancer: Systematic Evidence Review

Chapter III. Results

III. Results

This chapter presents the results of our systematic review on three main issues: screening

among women who are 65 years of age and older or who have had a hysterectomy, technologies

for cervical cytology, and testing the human papilloma virus (HPV) as a part of cervical cancer

screening. Evidence Tables detailing information from the literature examined by members of

the RTI-University of North Carolina Evidence-based Practice Center (RTI-UNC EPC) can be

found in Appendix C.

Key Question 1

Screening Among Women Age 65 and Older

Twelve articles since 1995 provided sufficiently detailed information about results of

screening by age to examine the evidence about screening among older women (Evidence Table

1A, Appendix C). For inclusion, we required that the study include women above age 50, that

data be presented stratified by age or in subanalyses that compared older to younger women, and

that the denominators for the outcomes be known (e.g., the number of abnormal Pap results

reported corresponds to a defined number of individual women screened or number of Pap tests

obtained in a specified group of women). The majority of rejected studies were ecologic-level

reports correlating population-based rates of detection of dysplasia and/or cancer with Pap

testing trends, or case-control studies that matched on age and contributed only to the literature

about interval, or models validated using data that would not meet the inclusion criteria.

39