Page 162 - Screening for Cervical Cancer: Systematic Evidence Review

Chapter I: Introduction

Age to stop screening Not mentioned Until age 69 General cancer check-up recommen- dations suggest annual exam continue past menopause Age 65 Age 64

Interval for “High Risk” Not mentioned More frequently than 3 years Not mentioned Annually until no longer show dysplasia within 5 years Not mentioned

Recommendations of Other Groups about Pap Smear for Cervical Cancer Screening (cont’d)

Definition of High Risk Not mentioned Early onset of sexual intercourse; many sexual partners; sexual partner with many sexual partners Not mentioned Mandelblatt Risk Factor Table of Relative Risk Certain types of HVP; women with many sexual partners or whose partner has had many partners; long-term use of the pill; women who smoke

Screening Interval At least every 3 years Two annual screens, then every 3 years Annually until 3 or more consecutive satisfactory examinations, then at physician discretion 3 consecutive normal smears and no dysplasia within 5 years, then less frequently, but at least every 3 years At least every 5 years (free cervical smear test)

Parameters Women who have ever had sex and have a cervix Women > age 18 who have had sexual Sexually active or Age18 (as prior Sexually active women younger than age 18 and all women aged 18-64. Omit women who hysterectomy with no residual cervix Age 20. Omit women who have had a total hysterectomy for nonmalignant

Test intercourse entries) have had a reasons

Table 2: Organization American Academy of Family Physicians, 1996 Canadian Task Force on Preventive Health Care, 1992 American Cancer Society, 2000 Institute for Clinical Systems Improvement, 2000 UK National Health Service Cancer Screening Progammes, 1999

24