Skip to main content

Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers.

Publication ,  Journal Article
Holt, HK; Kulasingam, S; Sanstead, EC; Alarid-Escudero, F; Smith-McCune, K; Gregorich, SE; Silverberg, MJ; Huchko, MJ; Kuppermann, M; Sawaya, GF
Published in: MDM Policy Pract
2020

Purpose. In 2018, the US Preventive Services Task Force (USPSTF) endorsed three strategies for cervical cancer screening in women ages 30 to 65: cytology every 3 years, testing for high-risk types of human papillomavirus (hrHPV) every 5 years, and cytology plus hrHPV testing (co-testing) every 5 years. It further recommended that women discuss with health care providers which testing strategy is best for them. To inform such discussions, we used decision analysis to estimate outcomes of screening strategies recommended for women at age 30. Methods. We constructed a Markov decision model using estimates of the natural history of HPV and cervical neoplasia. We evaluated the three USPSTF-endorsed strategies, hrHPV testing every 3 years and no screening. Outcomes included colposcopies with biopsy, false-positive testing (a colposcopy in which no cervical intraepithelial neoplasia grade 2 or worse was found), treatments, cancers, and cancer mortality expressed per 10,000 women over a shorter-than-lifetime horizon (15-year). Results. All strategies resulted in substantially lower cancer and cancer death rates compared with no screening. Strategies with the lowest likelihood of cancer and cancer death generally had higher likelihood of colposcopy and false-positive testing. Conclusions. The screening strategies we evaluated involved tradeoffs in terms of benefits and harms. Because individual women may place different weights on these projected outcomes, the optimal choice for each woman may best be discerned through shared decision making.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

MDM Policy Pract

DOI

EISSN

2381-4683

Publication Date

2020

Volume

5

Issue

2

Start / End Page

2381468320952409

Location

United States

Related Subject Headings

  • 4407 Policy and administration
  • 4206 Public health
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Holt, H. K., Kulasingam, S., Sanstead, E. C., Alarid-Escudero, F., Smith-McCune, K., Gregorich, S. E., … Sawaya, G. F. (2020). Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers. MDM Policy Pract, 5(2), 2381468320952409. https://doi.org/10.1177/2381468320952409
Holt, Hunter K., Shalini Kulasingam, Erinn C. Sanstead, Fernando Alarid-Escudero, Karen Smith-McCune, Steven E. Gregorich, Michael J. Silverberg, Megan J. Huchko, Miriam Kuppermann, and George F. Sawaya. “Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers.MDM Policy Pract 5, no. 2 (2020): 2381468320952409. https://doi.org/10.1177/2381468320952409.
Holt HK, Kulasingam S, Sanstead EC, Alarid-Escudero F, Smith-McCune K, Gregorich SE, et al. Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers. MDM Policy Pract. 2020;5(2):2381468320952409.
Holt, Hunter K., et al. “Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers.MDM Policy Pract, vol. 5, no. 2, 2020, p. 2381468320952409. Pubmed, doi:10.1177/2381468320952409.
Holt HK, Kulasingam S, Sanstead EC, Alarid-Escudero F, Smith-McCune K, Gregorich SE, Silverberg MJ, Huchko MJ, Kuppermann M, Sawaya GF. Discussing Cervical Cancer Screening Options: Outcomes to Guide Conversations Between Patients and Providers. MDM Policy Pract. 2020;5(2):2381468320952409.

Published In

MDM Policy Pract

DOI

EISSN

2381-4683

Publication Date

2020

Volume

5

Issue

2

Start / End Page

2381468320952409

Location

United States

Related Subject Headings

  • 4407 Policy and administration
  • 4206 Public health