Page 99 - 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 Consideration
N = 287,295 N/A (identified Primary AGE: Denom=2
Pap smears cases at entry outcome = Within the age groups from 30-54 Attrition=DNA
into screening) histologically age/cohort specific rates of CIN 3 are Indications=0
Age 20-60 at proven CIN3 increasing over secular time. Patterns (DNA)
first screening (n=648) are variable among older age groups Interval=0 DNA
or first over time. Age=2
screening within Relevance=0.5
10 years Recent rates by age: Standard=2
Age 20-24 1.58 cases/1000py Score=6.5
25-9 2.51
30-4 4.94 Grade=Poor
35-9 4.01
40-4 4.29
45-9 3.40
50-4 3.90
55-9 1.88

N = 118,890 Not specified Primary AGE: 17% of smears from women Denom=2
women with outcome = ≥50 yoa. CIS among ≥ 50 was 4.6%. Attrition=1
466,259 Pap cancer in situ Therefore detection ratio per thousand Indications=2
smears in n=1076 smears of 0.63. Contrasted with peak Interval=1
registry before detection ratio of 3.3 for women ages Age=2
diagnosis of 25-35; and combined ratio for those Relevance=1
cancer in situ or under 50 of 2.6. Standard=2
invasive cancer Score=11
AGE & SCREENING HISTORY:
(Subanalysis – n = 5,893) Grade=Fair
Among women with 3 normal smears
between 41 and 49, 60 (1%) had
Class 3-5 smear after 50, including 4
CIS, 3 invasive cancers and 2
adenocarcinomas

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