Frequency and outcome of cervical cancer prevention failures in the United States

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

doi:10.1309/97JHG6GLY69BVF4Y

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Frequency and outcome of cervical cancer prevention failures in the United States

Journal article

Open access

Peer reviewed

Frequency and outcome of cervical cancer prevention failures in the United States

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 and Kim R GEISINGER

American journal of clinical pathology, Vol.128(5), pp.817-824

2007

DOI: 10.1309/97JHG6GLY69BVF4Y

PMID: 17951205

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Abstract

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.

Tumors

Gynecology. Andrology. Obstetrics

Investigative techniques, diagnostic techniques (general aspects)

Pathology. Cytology. Biochemistry. Spectrometry. Miscellaneous investigative techniques

Biological and medical sciences

Medical sciences

Female genital diseases

Details

Title: Subtitle: Frequency and outcome of cervical cancer prevention failures in the United States
Creators: Stephen S RAAB - Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Dana Marie GRZYBICKI - Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Richard J ZARBO - Department of Pathology, Henry Ford Health System, Detroit, MI, United States
Chris JENSEN - Department of Pathology, University of Iowa Healthcare, Iowa City, United States
Stanley J GEYER - Department of Pathology, Western Pennsylvania Hospital, Pittsburgh, United States
Janine E JANOSKY - Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Frederick A MEIER - Department of Pathology, Henry Ford Health System, Detroit, MI, United States
Colleen M VRBIN - Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Gloria CARTER - Department of Pathology, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
Kim R GEISINGER - Department of Pathology, Wake Forest School of Medicine, Winston-Salem, NC, United States
Resource Type: Journal article
Publication Details: American journal of clinical pathology, Vol.128(5), pp.817-824
Publisher: American Society of Clinical Pathologists; Chicago, IL
DOI: 10.1309/97JHG6GLY69BVF4Y
PMID: 17951205
ISSN: 0002-9173
eISSN: 1943-7722
Language: English
Date published: 2007
Academic Unit: Pathology
Record Identifier: 9984047982102771

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