Cervical Cancer Screening in Average-Risk Women: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians

2015 ◽  
Vol 162 (12) ◽  
pp. 851 ◽  
Author(s):  
George F. Sawaya ◽  
Shalini Kulasingam ◽  
Thomas D. Denberg ◽  
Amir Qaseem ◽  
2020 ◽  
Vol 70 (5) ◽  
pp. 321-346 ◽  
Author(s):  
Elizabeth T. H. Fontham ◽  
Andrew M. D. Wolf ◽  
Timothy R. Church ◽  
Ruth Etzioni ◽  
Christopher R. Flowers ◽  
...  

2021 ◽  
Vol 4 (4) ◽  
pp. e218373
Author(s):  
Jason D. Wright ◽  
Ling Chen ◽  
Ana I. Tergas ◽  
Alexander Melamed ◽  
Caryn M. St. Clair ◽  
...  

2018 ◽  
Vol 36 (4) ◽  
pp. 395-401 ◽  
Author(s):  
Thuy N Thai ◽  
Thanh C Bui ◽  
Mark H Ebell

Abstract Background Determining risk scores for genital high-risk human papillomavirus (HRHPV) infection in women will support more efficient cervical cancer screening strategies. Objective We developed and validated point scores to predict the likelihood of any genital HRHPV infection in women. Methods We conducted the cross-sectional analysis in 2017 and used data from the 2005–14 US National Health and Nutrition Examination Survey (7337 women aged 25–59 years; 6300 women aged 30–59 years). Predictors were reproductive health practices, risk behaviors and demographic variables. The outcome was a positive result for any of the 21 genital HRHPV genotypes. The 2005–12 cohorts were used as training and testing sets to develop scores that best classified women into three risk groups: low risk (<20%), average risk (20–30%) and high risk (>30%). The 2013–14 cohort was used to validate the final scores. Results Two-point scores with six self-reported variables were created to predict any HRHPV risks for the two age groups: the Personal Risk of Oncogenic HPV (PRO-HPV25) for women aged 25–59 years old and PRO-HPV30 for women aged 30–59 years old. The scores were successfully prospectively validated, with good calibration with regards to the predicted and observed rates of HRHPV infection. The scores had fair discrimination (c-statistics: 0.67–0.68). Conclusion The PRO-HPV risk scores can identify groups at low, average and high risk of genital HRHPV infection. This information can be used to prioritize women for cervical cancer screening in low-resource settings or to personalize screening intervals.


2014 ◽  
Vol 13s3 ◽  
pp. CIN.S14035 ◽  
Author(s):  
Kavishwar B. Wagholikar ◽  
Kathy L. Maclaughlin ◽  
Petra M. Casey ◽  
Thomas M. Kastner ◽  
Michael R. Henry ◽  
...  

Because of the complexity of cervical cancer prevention guidelines, clinicians often fail to follow best-practice recommendations. Moreover, existing clinical decision support (CDS) systems generally recommend a cervical cytology every three years for all female patients, which is inappropriate for patients with abnormal findings that require surveillance at shorter intervals. To address this problem, we developed a decision tree-based CDS system that integrates national guidelines to provide comprehensive guidance to clinicians. Validation was performed in several iterations by comparing recommendations generated by the system with those of clinicians for 333 patients. The CDS system extracted relevant patient information from the electronic health record and applied the guideline model with an overall accuracy of 87%. Providers without CDS assistance needed an average of 1 minute 39 seconds to decide on recommendations for management of abnormal findings. Overall, our work demonstrates the feasibility and potential utility of automated recommendation system for cervical cancer screening and surveillance.


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