| Cervical
cancer is a silent cancer; it rarely causes
pain or noticeable symptoms until it is
so advanced that it is unresponsive to
treatment. However, cervical cancer is
one of the most successfully treatable
cancers when detected early, with a cure
rate approaching 100 percent if the patient
is identified and treated in an opportune
stage.
Increased screening has resulted in a
major overall decline in mortality from
cervical cancer over the past several
decades, estimated to reduce cervical
cancer by up to 70 %. Unfortunately, a
significant number of women still develop
the disease and are diagnosed at a late
stage. In 2005, an estimated 10,370 new
cases of cervical cancer will be diagnosed,
resulting in an expected 3,700 deaths.
Many or all of these deaths could be eliminated
with timely and effective screening.
Screening guidelines differ slightly
by source (US Preventive Services Task
Force, National Cancer Institute, American
Cancer Society, and the American College
of Obstetrics & Gynecology), but to
summarize:
a. Screening for cervical cancer is advised
in women who have been sexually active
and have a cervix.
b. Screening should begin within 3 years
of onset of sexual activity or age 21
(whichever comes first) and should be
repeated at least every 3 years.
c. The ACS and ACOG guidelines recommend
that women 70 years or older who have
had three or more documented, consecutive,
technically satisfactory normal (negative)
cervical cytology tests, and who have
had no abnormal ( positive) cytology tests
within the last 10 years, may safely discontinue
screening. (65 years for the USPSTF )
Note : USPSTF suggests waiting until age
30 before lengthening the screening interval;
the American College of Obstetricians
and Gynecologists (ACOG) identifies additional
risk factors that might justify annual
screening, including a history of cervical
neoplasia, infection with HPV or other
STDs, or high-risk sexual behavior, but
data are limited in determining the benefits
of these strategies.
d. ACOG recommends women infected with
HIV should have cervical cytology screening
twice in the first year after diagnosis
and annually thereafter. Women treated
in the past for CIN 2 or CIN 3 or cancer
remain at risk for persistent or recurrent
disease and should continue annual screenings.
Women with previously normal cervical
cytology results whose most recent cervical
cytology sample lacked endocervical cells
or transformation zone components, and
those with partly obscuring red or white
blood cells should be re-screened in 1
year.
For more info on Cancer screening see:
http://www.cancer.gov/cancertopics/screening
&
For information on this measure, see:
http://healthdisparities.net/hdc/Library/7-19-2005.7366/CancerMeasures_Mar05.pdf
http://www.ncqa.org/docs/SOHCQ_2005.pdf
(page 31)
For information on treatment, see:
http://www.cancer.gov/cancertopics/treatment
&
The US Preventive Services Task Force
strongly supports such screening: http://www.ahrq.gov/clinic/3rduspstf/cervcan/cervcanrr.pdf
http://www.ncbi.nlm.nih.gov
Screening has been proven to prevent
and/or ameliorate the course of a number
of serious medical conditions. Early and
regular screening for cancer is one of
our most effective tools. Much suffering,
disability as well as deaths can be avoided
if more people were screened for cancer.
This measure examines the continuity
of care at health center grantees for
cancer screening including provider education,
patient outreach and health education;
follow up, referral, and appointment systems
for the existing cancer screening protocol.
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