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Conventional, annual Pap smear cost-effective follow-up after cervical lesion treatment
Date:10/20/2010

(SACRAMENTO, Calif.) A study of the options for reducing cancer incidence and mortality among women who have been treated for precancerous cervical lesions found that an annual conventional Pap smear is a cost effective strategy.

Joy Melnikow, professor in the Department of Family and Community Medicine and colleagues tested several follow-up screening strategies for the 500,000 American women diagnosed and treated for cervical intraepithelial neoplasia (CIN), abnormal cervical cell growth that can lead to cervical cancer. The first comprehensive study of its kind, "Surveillance After Treatment for Cervical Intraepithelial Neoplasia" will be published in the November issue of Obstetrics & Gynecology.

"This is a large and growing pool of women who need follow-up after treatment," said Melnikow, who is also director of the UC Davis Center for Healthcare Policy and Research. "But we've had few studies on which to base recommendations for follow-up."

Detection and treatment of these pre-cancerous lesions have led to large reductions in cervical cancer incidence and death in many countries where screening is routine. But current recommendations about follow-up over time vary widely, and the use of newer technologies had not been fully evaluated until now, Melnikow said.

Melnikow and her colleagues examined the relative benefits and costs for different strategies, including the frequency of follow-up testing. "What we learned was that the newer technologies such as liquid-based Pap testing and HPV (human papillomavirus ) testing add considerable cost but little to no benefit compared with conventional Pap smear follow-up," she said.

Among the options currently in use for women who have undergone treatment for CIN are conventional cervical cytology (Pap test) at six and 12 months followed by routine Pap testing if these tests are negative. Some patients are given colposcopy (an examination of the cervix using a m
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Contact: Dorsey Griffith
dorsey.griffith@ucdmc.ucdavis.edu
916-734-9118
University of California -- Davis - Health System
Source:Eurekalert

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