Document Detail


Frequency and outcome of cervical cancer prevention failures in the United States.
MedLine Citation:
PMID:  17951205     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We measured the frequency and outcome of cervical cancer prevention failures that occurred in the Papanicolaou (Pap) and colposcopy testing phases involving 1,646,580 Pap tests in 4 American hospital systems between January 1, 1998, and December 31, 2004. We defined a screening failure as a 2-step or greater discordant Pap test result and follow-up biopsy diagnosis. A total of 5,278 failures were detected (0.321% of all Pap tests); 48% and 52% of failures occurred in the Pap test and colposcopy phases, respectively. Missed squamous cancers (1 in 187,786 Pap tests), glandular cancers (1 in 19,426 Pap tests), and high-grade lesions (1 in 6,870 Pap tests) constituted 4.1% of all failures. Unnecessary repeated tests or diagnostic delays occurred in 70.8% and 63.9% of failures involving high- and low-grade lesions, respectively. We conclude that cervical cancer prevention practices are remarkably successful in preventing squamous cancers, although a high frequency of failures results in low-impact negative outcomes.
Authors:
Stephen S Raab; Dana Marie Grzybicki; Richard J Zarbo; Chris Jensen; Stanley J Geyer; Janine E Janosky; Frederick A Meier; Colleen M Vrbin; Gloria Carter; Kim R Geisinger
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  American journal of clinical pathology     Volume:  128     ISSN:  0002-9173     ISO Abbreviation:  Am. J. Clin. Pathol.     Publication Date:  2007 Nov 
Date Detail:
Created Date:  2007-10-22     Completed Date:  2007-11-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370470     Medline TA:  Am J Clin Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  817-24     Citation Subset:  AIM; IM    
Affiliation:
Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, and Western Pennsylvania Hospital 15232, USA.
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MeSH Terms
Descriptor/Qualifier:
Colposcopy / standards,  statistics & numerical data*
Diagnostic Errors / standards,  statistics & numerical data*
Female
Humans
Mass Screening / standards,  statistics & numerical data*
Neoplasm Staging
Patient Care Management / statistics & numerical data
Predictive Value of Tests*
Reproducibility of Results
Uterine Cervical Neoplasms / diagnosis*,  prevention & control
Vaginal Smears / standards,  statistics & numerical data*
Grant Support
ID/Acronym/Agency:
HJS13321-01//PHS HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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