Interval cancer audit and disclosure in cervical screening programmes: An international survey

2021 ◽  
pp. 096914132110623
Author(s):  
Patricia Fitzpatrick ◽  
Therese Mooney ◽  
Helen Byrne ◽  
Orla Healy ◽  
Noirin Russell ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Detection ◽  
Cervical Screening ◽  
Interval Cancer ◽  
Population Based ◽  
Audit Process ◽  
Detection Rates ◽  
Legal Cases ◽  
Cervical Cancers ◽  
International Comparative

Background Legal cases involving the National Cervical Screening Programme in Ireland following non-disclosure of an interval cervical cancer audit prompted this first international comparative survey of interval cervical cancer audit. Methods A survey of 22 international population-based cervical screening programmes was conducted, to determine if they undertook audit of invasive cervical cancers. Those countries/regions that perform reviews were asked (i) how the audit was undertaken, including how the reviews were performed and how they controlled for retrospective bias, (ii) how women are informed of the audit process and how their consent is obtained, and (iii) how audit results were disclosed to patients. Results Seventeen countries/regions invited completed the survey (77%); 65% (11/17) have an audit process for interval cervical cancers. Five perform individual patient reviews; three perform programme-wide review, with calculation of interval cancer detection rates; one routinely performs programme-wide review with calculation of interval cancer detection rates and offers individual reviews, and one routinely performs local hospital-level reviews. In the remaining country/region, hospital laboratories audit cancers, with a national audit process for all cervical cancers. Varying methodologies for retrospective cytology review were employed; four include control samples, with a ratio varying from 1:1 to 1:2. Three conduct a blinded review. Most countries/regions do not discuss interval cancer audit with participants and 3/11 (27.3%) inform women when a cervical cancer audit takes place. Disclosure is limited and variable. Conclusion The responses suggest that there is no consistent approach to audit of interval cervical cancers or to disclosure of audit results.

scholarly journals Automated Quantitative Cytology Imaging Analysis System in Cervical Cancer Screening in Shanxi Province, China

2017 ◽  
Vol 6 (2) ◽  
pp. 51 ◽  
Author(s):  
Yan Dong ◽  
Jigeng Bai ◽  
Yuping Zhang ◽  
Guangjie Shang ◽  
Yan Zhao ◽  
...  
Keyword(s):  
Artificial Intelligence ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Population Based ◽  
Shanxi Province ◽  
Detection Rates ◽  
Screening Programs ◽  
Quantitative Cytology ◽  
Automated Platform

Purpose: In China the number of pathologists is far from being enough to meet the demands of ongoing population based cervical cancer screening programs. This article aims to present our experience with automated quantitative cytology imaging platform, a reading system with an artificial intelligence that we currently use routinely for cervical cancer screening in Shanxi province.Methods: From 2012-2016 a total of 40 178 women were screened. Women were divided into three groups and each group had two subgroups. Smear and liquid based technique were compared using manual and automated platform.Results: Detection rates of CIN2 + and positive rates of CIN2 were higher in all three groups when automated quantitative cytology platform was used compared with groups where reading was done by the pathologist using conventional microscope. Operator’s costs associated with automated quantitative cytology platform vs. conventional reading using light microscope were compared too. The overall costs of operations based on automated platform were proven to be lower.Conclusion: The use of automated platform and artificial intelligence as a means to overcome the lack of cytotechnologists and pathologists and to implement proper quality control in the large scale population based cervical cancer screening seems very promising.

Impact of media reporting of cervical cancer in a UK celebrity on a population-based cervical screening programme

2011 ◽  
Vol 18 (4) ◽  
pp. 204-209 ◽  
Author(s):  
Georgina J Macarthur ◽  
Melissa Wright ◽  
Helen Beer ◽  
Shantini Paranjothy
Keyword(s):  
Cervical Cancer ◽  
Screening Programme ◽  
Cervical Screening ◽  
Population Based ◽  
Media Reporting

scholarly journals Javaslat a hazai méhnyakszűrési eljárásrend korszerűsítésére

2017 ◽  
Vol 158 (52) ◽  
pp. 2062-2067
Author(s):  
Róbert Koiss ◽  
Imre Boncz ◽  
Zoltán Hernádi ◽  
Zoltán Szentirmay
Keyword(s):  
Cervical Screening ◽  
Screening Method ◽  
Interval Cancer ◽  
Human Papilloma Virus Infection ◽  
Population Based ◽  
Screening Strategy ◽  
Biological Behavior ◽  
Papilloma Virus ◽  
Interval Cancer Rate ◽  
Increased Sensitivity

Abstract: Two main considerations played roles in creation of new cervical screening system. One was the proven fact that high-risk human papilloma virus infection plays a role in the development of cervical cancer and pre-cancerous lesions. The other was the implementation of the HPV infection’s biological behavior in the new screening strategy. The new screening procedure faithfully reflects the cervical carcinogenesis. An organised, population-based and age differentiated screening method could increase attendance of screening and could decrease the possibility of interval cancer rate due to increased sensitivity. Orv Hetil. 2017; 158(52): 2062–2067.

scholarly journals Organized primary human papillomavirus–based cervical screening: A randomized healthcare policy trial

PLoS Medicine ◽  
2021 ◽  
Vol 18 (8) ◽  
pp. e1003748
Author(s):  
K. Miriam Elfström ◽  
Carina Eklund ◽  
Helena Lamin ◽  
Daniel Öhman ◽  
Maria Hortlund ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Detection Rate ◽  
Screening Program ◽  
Cervical Screening ◽  
Real Life ◽  
Intraepithelial Neoplasia ◽  
Population Based ◽  
Healthcare Policy ◽  
Cervical Intraepithelial Neoplasia Grade ◽  
Detection Rates

Background Clinical trials in the research setting have demonstrated that primary human papillomavirus (HPV)-based screening results in greater protection against cervical cancer compared with cytology, but evidence from real-life implementation was missing. To evaluate the effectiveness of HPV-based cervical screening within a real-life screening program, the organized, population-based cervical screening program in the capital region of Sweden offered either HPV- or cytology-based screening in a randomized manner through a randomized healthcare policy (RHP). Methods and findings A total of 395,725 women aged 30 to 64 years that were invited for their routine cervical screening visit were randomized without blinding to either cytology-based screening with HPV triage (n = 183,309) or HPV-based screening, with cytology triage (n = 212,416 women) between September 1, 2014 and September 30, 2016 and follow-up through June 30, 2017. The main outcome was non-inferior detection rate of cervical intraepithelial neoplasia grade 2 or worse (CIN2+). Secondary outcomes included superiority in CIN2+ detection, screening attendance, and referral to histology. In total, 120,240 had a cervical screening sample on record in the study period in the HPV arm and 99,340 in the cytology arm and were followed for the outcomes of interest. In per-protocol (PP) analyses, the detection rate of CIN2+ was 1.03% (95% confidence interval (CI) 0.98 to 1.10) in the HPV arm and 0.93% (0.87 to 0.99) in the cytology arm (p for non-inferiority <0.0001; odds ratio (OR) 1.11 (95% CI 1.02 to 1.22)). There were 46 cervical cancers detected in the HPV arm (0.04% (0.03 to 0.06)) and 48 cancers detected in the cytology arm (0.05% (0.04 to 0.07)) (p for non-inferiority <0.0001; OR 0.79 (0.53 to 1.18)). Intention-to-screen (ITS) analyses found few differences. In the HPV arm, there was a modestly increased attendance after new invitations (68.56% (68.31 to 68.80) vs. 67.71% (67.43 to 67.98); OR 1.02 (1.00 to 1.03)) and increased rate of referral with completed biopsy (3.89% (3.79 to 4.00) vs. 3.53% (3.42 to 3.65); OR 1.10 (1.05 to 1.15)). The main limitations of this analysis are that only the baseline results are presented, and there was an imbalance in invitations between the study arms. Conclusions In this study, we observed that a real-life RHP of primary HPV-based screening was acceptable and effective when evaluated against cytology-based screening, as indicated by comparable participation, referral, and detection rates. Trial registration ClinicalTrials.gov NCT01511328

scholarly journals Results from the NHS Breast Screening Programme 1990–1993

1995 ◽  
Vol 2 (4) ◽  
pp. 186-190 ◽  
Author(s):  
S M Moss ◽  
M Michel ◽  
J Patnick ◽  
L Johns ◽  
R Blanks ◽  
...  
Keyword(s):  
Cancer Detection ◽  
Breast Screening ◽  
Detection Rate ◽  
Screening Programme ◽  
Interval Cancer ◽  
Cancer Detection Rate ◽  
Quality Assurance Programme ◽  
Detection Rates ◽  
Breast Screening Programme ◽  
Single View

Objective –To present results from the NHS breast screening programme (NHSBSP) for the three year period 1990 to 1993, and to examine the extent to which interim targets are being met. Methods –Data have been collated from all screening programmes in the United Kingdom on standard “Korner” returns, supplemented for the year 1991/92 by data from the radiology quality assurance programme. Most of the data refer to the prevalent screening round, but some data on rescreening are also available. Results –The total cancer detection rate at prevalent screens was 6·0/1000, 18% being in situ cancers; the detection rate of invasive cancers ⩽ 10 mm in diameter was 1·3/1000, but data on size were missing for 12% of cancers. Referral rates were significantly lower for programmes using' two view mammography at the prevalent screen than for those using single view, and cancer detection rates were significantly higher. For prevalent screens over the three year period, 70% of programmes had a referral rate of ≤ 7%, 87% had a benign biopsy rate of ≤ 5/1000, and 79% had a cancer detection rate of ≥ 5/1000. By contrast, only 30% of programmes appeared to meet the target detection rate of > ⩽5/1000 for invasive cancers ≤ 10 mm in diameter. Conclusions – While the majority of interim targets are being met by the NHSBSP, the rate of detection of small invasive cancers requires careful monitoring. Collection of more accurate data on size of cancers and interval cancer rates will give a better indication of progress towards the target mortality reduction.

How Effective is Population-Based Cancer Screening? Regression Discontinuity Estimates from the US Guideline Screening Initiation Ages

2016 ◽  
Vol 19 (1) ◽  
pp. 87-139 ◽  
Author(s):  
Srikanth Kadiyala ◽  
Erin Strumpf
Keyword(s):  
Breast Cancer ◽  
Colorectal Cancer ◽  
Cancer Screening ◽  
Cancer Detection ◽  
Regression Discontinuity ◽  
Early Stage ◽  
Population Based ◽  
Detection Rates ◽  
Asymptomatic Case ◽  
The Cost

Abstract We estimate the marginal benefits of population-based cancer screening by comparing cancer test and detection rates on either side of US guideline-recommended initiation ages (age 40 for breast cancer and age 50 for colorectal cancer during the study period). Using a regression discontinuity design and self-reported test data from national health surveys, we find test rates for breast and colorectal cancer increase at the guideline age thresholds by 109% and 78%, respectively. Data from cancer registries in twelve US states indicate that cancer detection rates increase at the same thresholds by 50% and 49%, respectively. We estimate significant effects of screening on earlier breast cancer detection (1.2 cases/1000 screened) at age 40 and colorectal cancer detection (1.1 cases/1000 individuals screened) at age 50. Forty-eight and 73% of the increases in breast and colorectal case detection occur among middle-stage cancers (localized and regional) with most of the remainder among early-stage (in-situ). Our analysis suggests that the cost of detecting an asymptomatic case of breast cancer at age 40 via population-based screening is $107,000–134,000 and that the cost of detecting an asymptomatic case of colorectal cancer at age 50 is $473,000–485,000.

scholarly journals Cervical Screening and Cervical Cancer Death Among Older Women: A Population-Based, Case-Control Study

2014 ◽  
Vol 179 (9) ◽  
pp. 1107-1114 ◽  
Author(s):  
A. S. Rustagi ◽  
A. Kamineni ◽  
S. Weinmann ◽  
S. D. Reed ◽  
P. Newcomb ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Older Women ◽  
Case Control Study ◽  
Cervical Screening ◽  
Population Based ◽  
Case Control ◽  
Cancer Death ◽  
Control Study
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