Page 5 - Screening for Cervical Cancer: Systematic Evidence Review

Table of Contents

Table of Contents

List of Tables and Figures............................................................................................................ viii

Abstract.......................................................................................................................................... ix

I. Introduction..........................................................................................................................1
Background..........................................................................................................................1
Uniform Terminology for Cervical Lesions ........................................................................2
Burden of Suffering .............................................................................................................2
Epidemiology.......................................................................................................................3
Risk Factors .............................................................................................................3
Role of Human Papilloma Virus..............................................................................3
Screening Failures....................................................................................................5
Screening Tools ...................................................................................................................6
Cervical Cytology: Conventional and New Technologies......................................7
Tools for HPV Testing.............................................................................................9
Health Care Interventions ..................................................................................................10
Prior Recommendations.....................................................................................................12
US Preventive Services Task Force.......................................................................12
Recommendations of Other Groups.......................................................................13
Analytic Framework and Key Questions...........................................................................14
Analytic Framework ..............................................................................................14
Key Questions........................................................................................................15
Relevant Outcomes ................................................................................................16

II. Methods..............................................................................................................................26
Literature Search Strategy..................................................................................................26
Inclusion/Exclusion Criteria ..............................................................................................27
Literature Reviewed...........................................................................................................28
Citation Database...................................................................................................28
Screening of Articles..........................................................................................................28
Key Question 1: Screening Among Older Women and After Hysterectomy.......29
Key Question 2: New Technologies for Cytology................................................30
Key Question 3: What is the Role of HPV Testing? ............................................32
Cost and Harms......................................................................................................32
Literature Synthesis and Preparation of Systematic Evidence Review .............................34
Data Abstraction and Development of Evidence Tables .......................................34
Peer Review Process..............................................................................................35

III. Results ................................................................................................................................39
Key Question 1 ..................................................................................................................39
Screening Among Women Age 65 and Older .......................................................39
Incidence and Age..................................................................................................41
Prevalence..............................................................................................................42

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