Page 105 - 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
1) 368,051 Recommends Primary AGE: Denom=2
women with screening every outcome = Attrition=1
normal Pap in 2 yrs after a microinvasive Interval cancer rate: (95%CI) Indications=0
1990 negative Pap, and invasive Age <35: 2.54/100,000 (1.5, 4.3) Interval=2
Age <70 stopping at 70 cervical cancer Ages 35-69: 2.53/100,000 (1,5, 4.3) Age=0
as documented Relevance=1
2) 233 women by cancer INTERVAL: Standard=2
with new registry which Score=8
diagnosis of includes Of 167 women with diagnosis of
cervical cancer histology squamous cell cancer, 34 (20%) had Grade=Poor
in 1993 (all a negative Pap report within the
ages) preceding 3 years

N = 30,527 Call and recall Primary AGE Denom=2
women 25,216 screening outcome = Non-neg. N % Attrition=2
hysterectomy system to “non-negative Smear Screened Non-neg Indications=2
achieve smear” defined 50-53 161 10,365 1.4 Interval=2
Born between screening every as borderline 54-57 54 8,913 0.6 Age=1
58-60 14 6,469 0.2
10/2/33 & 3 years between atypia or Relevance=1
10/1/44 ages 20-60 greater Histology among 164 women who Standard=1
(i.e. 50-60 at n= 229 had biopsy for non-negative smear Score=11
time of More than 93% Negative 27
analysis); and of population Secondary Viral changes only 16 Grade=Fair
without has been outcome = CIN 1 13
hysterectomy screened at Histologic CIN 2 19
least once diagnoses CIN 3 70
Micro-invasive* 4
Invasive cancer* 4
Clinically detected 7

Other 4
* Screen detected

Of 8 cancers, 1 first screened after
age 50; 3 had prior known abnormal
smears; 2 had their two prior smears
at intervals >5 yrs; 1 between 4-5
years. None were found who had
interval
≤ 3 years with normal smears

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