Screening for cervical cancer
Article Abstract:
Screening for cervical cancer is available by means of a simple test. The Papanicolaou (Pap) smear was developed in the 1930s and is still the primary test used for the screening and detection of cervical cancer. Previous evidence indicated that cervical cancer screening should reduce the incidence of and death from this disease by approximately 90 percent. The effectiveness of this screening method has been reviewed in the medical literature and data from large screening programs have been analyzed. Studies conducted in various health care settings have indicated that screening with Pap smears is highly effective and can reduce the occurrence of invasive cancer by approximately 60 percent to more than 90 percent. The degree of protection is related to the interval between examinations and considerable protection is present even with long intervals of three to five years. The Pap smear itself is an inexpensive test and the medical cost includes clinic or office visit. Annual screening for three years is recommended for women over 18 years of age or women that are sexually active, according to the American Cancer Society, the National Cancer Institute, and the American College of Obstetricians and Gynecologists. If the annual examinations are negative, the frequency of screening can be reduced. Probability of dying from cervical cancer has been calculated according to various ages at which screening is initiated and the intervals between tests. The lifetime risk of ever developing invasive cervical cancer for a 20 year old asymptomatic woman of average risk is about 250 in 10,000, or 2.5 percent. The chance of dying from cervical cancer for that same woman is about 118 in 10,000, a 1.18 percent risk. Different screening intervals have been examined and the difference between one to four year intervals is not considered critical. Women with low and high risk should be identified and the frequency of screening of these women should take these risks into account. Physicians must also consider the possibility of false-positive and false-negative results and follow-up diagnostic procedures may be necessary. Cervical cancer screening is effective and the general recommendation for screening frequency is at least every three years starting in a woman's 20s and continuing into her 60s. Reduction in mortality is very high with screening and there is the potential to almost eliminate this disease. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
Screening for colorectal cancer
Article Abstract:
The most common fatal malignancy is colorectal cancer, which affects both men and women with the same frequency. It was estimated that about 150,000 new cases and over 60,900 deaths resulting from colorectal cancer will occur in the United States in 1990. Screening may be particularly effective in diagnosing this prevalent cancer, which can be detected and treated at an early stage. However, there is limited evidence of the effectiveness of screening for colorectal cancer, and the benefits and hazards associated with screening are not known. The aspects of the disease that influence decisions about screening, the availability of screening tests, evidence for the effectiveness of screening, and the benefits, costs, and risks of various screening strategies are reviewed. Indirect evidence, based on the natural history or course of colorectal cancer and the ability of tests to detect various types of tumors, suggests that screening for colorectal cancer decreases mortality. It was estimated that in the absence of screening, a 50-year-old person will have a 530-in-10,000 chance of developing colorectal cancer and a 250-in-10,000 chance of dying from this cancer in his or her lifetime. A mathematical model estimated that routine screening of persons between 50 and 75 years will reduce the chance of developing or dying from colorectal cancer by 10 to 75 percent, depending on the type and frequency of the screening method. It is recommended that persons aged 50 to 75 years, with an average risk of developing colorectal cancer, be screened yearly by fecal occult blood tests, and every three to five years by flexible sigmoidoscopy (examination of the colon with a fiberoptic device). It was also recommended that first-degree relatives of patients with colorectal cancer be screened every three to five years using a barium enema instead of sigmoidoscopy. (A barium enema is a procedure in which the radioactive substance barium is introduced into the colon to provide X-ray images of the entire colon.) (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: Annals of Internal Medicine
Subject: Health
ISSN: 0003-4819
Year: 1990
User Contributions:
Comment about this article or add new information about this topic:
- Abstracts: Screening for breast cancer. Screening for lung cancer. Screening for osteoporosis
- Abstracts: Lupus anticoagulant: clinical significance in anticardiolipin positive patients with systemic lupus erythematosus
- Abstracts: Synthesis of the active metabolite of vitamin D, 1,25(OH)2D3, by synovial fluid macrophages in arthritic diseases
- Abstracts: The current role of sonography in the detection of Down's syndrome. The transverse cerebellar diameter cannot be used to assess gestational age in the small for gestational age fetus
- Abstracts: A phase I/II trial of zidovudine, interferon-alpha, and granulocyte-macrophage colony-stimulating factor in the treatment of human immunodeficiency virus type I infection