Provider management of equivocal cervical cancer screening results among underserved women, 2009–2011: follow-up of atypical squamous cells of undetermined significance

Details

• Alternative Title:
  Cancer Causes Control
• Personal Author:
  Watson, Meg ; Benard, Vicki ; Lin, Lavinia ; Rockwell, Tanner ; Royalty, Janet
• Description:
  Purpose
  
  Reflex human papillomavirus (HPV) testing is the preferred triage option for most women diagnosed with atypical squamous cells of undetermined significance (ASC-US). This study was conducted to describe follow-up results of women with ASC-US Pap test results in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), focusing on HPV test use.
  
  Methods
  
  We examined the follow-up of 45,049 women in the NBCCEDP with ASC-US Pap tests during 2009–2011. Data on demographic characteristics, diagnostic procedures, and clinical outcomes were analyzed.
  
  Results
  
  NBCCEDP providers diagnosed 45,049 women (4.5 % of all Pap tests) with an ASC-US result. Of those, 28,271 (62.8 %) were followed with an HPV test, 3,883 (8.6 %) with a repeat Pap test, 6,592 (14.6 %) with colposcopy, and 6,303 were lost to follow-up (14.0 %). Women aged 40 and older were followed more often with an HPV test. White, black, and Asian/Pacific Islander women were followed more often with an HPV test after an ASC-US Pap compared to Hispanic and American Indian/Alaska Native (AI/AN) women. Among women with a positive HPV test on follow-up, almost 90 % continued with colposcopy as recommended. AI/AN women had the highest rates of HPV positivity (55.2 %) and of no follow-up (25.0 %).
  
  Conclusion
  
  This is the first analysis describing follow-up of ASC-US Pap test results in the NBCCEDP, providing a window into current management of ASC-US results. Findings raise concerns about persistent disparities among AI/AN women. During 2009–2011, nearly two-thirds of women with an ASC-US Pap test result were followed with an HPV reflex test.
  
  
• Subjects:
  Adult Atypical Squamous Cells Of The Cervix Colposcopy Early Detection Of Cancer Female Follow-Up Studies Humans Middle Aged Papanicolaou Test Papillomaviridae Papillomavirus Infections Pregnancy Uterine Cervical Dysplasia Uterine Cervical Neoplasms Vaginal Smears Vulnerable Populations

  More +
• Keywords:
  ASC-US HPV Testing NBCCEDP Pap Test
• Source:
  Cancer Causes Control. 2015; 26(5):759-764
• Pubmed ID:
  25794897
• Pubmed Central ID:
  PMC4431899
• Document Type:
  Journal Article
• Funding:
  CC999999/Intramural CDC HHSUnited States/
• Volume:
  26
• Issue:
  5
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:01cdc8975cff3b362a76718b15ab6a66428a22b15ecb3db3c011850f91ce5027
• Download URL:
  https://stacks.cdc.gov/view/cdc/31166/cdc_31166_DS1.pdf
• File Type:
  [PDF - 305.60 KB ]