Model highlights benefits and risks of cervical cancer screeni...( In an analysis based on a computer m...),Health

In an analysis based on a computer model, it appears that comparing the benefits and risks of different cervical cancer prevention approaches may help women and their physicians choose appropriate screening strategies, according to a report in the September 22 issue of Archives of Internal Medicine, one of the JAMA/Archives journals.

Routine screening with cervical cytologic testing, commonly known as Pap smears, is credited with reducing the incidence of cervical cancer through the early detection of abnormal cells, according to background information in the article. Today, U.S. women have an average lifetime cervical cancer risk of 0.7 percent. Recently, even more sensitive DNA testing for the human papillomavirus (HPV), which contributes to cervical cancer, has become available, along with vaccines against HPV. This leaves women and their physicians with several prevention options and considerations.

Natasha K. Stout, Ph.D., and colleagues at the Harvard School of Public Health, Boston, used a computerized simulation model of cervical cancer in the United States to assess the benefits and risks associated with various screening strategies. The strategies differed by type of primary screening test, process for handling abnormal results and screening frequency. "These strategies pose trade-offs between minimizing cancer risk (already small with regular screening) and minimizing the risk of false-positive test results and excessive diagnostic procedures," the authors write.

Differences in women's lifetime cancer risk varied little between screening strategies; however, the difference between the strategy offering the least and most frequent referrals for colposcopy (a procedure in which physicians look directly at the cervix through a microscope) was three-fold. For a representative group of 1,000 20-year-old women undergoing annual screening for 10 years, combined cytologic and HPV testing would lead to an estimated 1,795 ref
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