Screening Of High-risk Women Research Articles

Appropriateness of cervical cancer screening

For the Pap test to be appropriate for the early detection of cervical cancer there should be good evidence that it is effective, its expected benefits should outweigh any risks, and its costs should be reasonable. Although the value of the Pap test has never been determined in a randomized controlled trial, its effectiveness has been demonstrated indirectly in dozens of clinical and epidemiological studies conducted over the past 3 decades. This paper reviews that evidence. It also examines in detail the effectiveness, costs, and potential risks of delivering the test at various frequencies. Issues discussed include the yield of invasive cancers, the results of large screening programs in which the test was delivered at different frequencies, statistical estimates of the “cost/effectiveness” of screening at different frequencies, the false-negative rate, laboratory quality control, and the screening of high-risk women.