The frequency of cervical cancer screening. Comparison of a mathematical model with empirical data

The results of a mathematical model used to analyze the frequency of the Pap smear are compared with a recently published independent empirical study of data from large screening programs in Europe and North America. The model's predictions of the reduced incidence of invasive cervical cancer achieved with different screening frequencies match the empirical results closely—the predictions were within 1% of the empirical results for screening frequencies ranging from 1 to 10 years. The data indicate that compared with annual screening, screening every 2, 3, 5, and 10 years retains 99%, 97%, 89%, and 69%, respectively, of the effectiveness measured as a reduction in frequency of invasive cancer. The mathematical model underestimated the effectiveness of screening every 3 years, compared with screening every year.

[1]  D. Eddy A Mathematical Model for Timing Repeated Medical Tests , 1983, Medical decision making : an international journal of the Society for Medical Decision Making.

[2]  J. Cuzick,et al.  PROGRESSIVE POTENTIAL OF MILD CERVICAL ATYPIA: PROSPECTIVE CYTOLOGICAL, COLPOSCOPIC, AND VIROLOGICAL STUDY , 1986, The Lancet.

[3]  David M. Eddy,et al.  Screening for cancer : theory, analysis, and design , 1984 .

[4]  J. E. Dunn,et al.  The duration of intraepithelial and preclinical squamous cell carcinoma of the uterine cervix. , 1970, American journal of epidemiology.

[5]  T. Louis,et al.  Screening for the early detection of cancer- II. The impact of screening on the natural history of the disease , 1978 .

[6]  R. Deitch Commentary from Westminster , 1984, The Lancet.

[7]  R. M. Briggs Dysplasia and early neoplasia of the uterine cervix. A review. , 1979, Obstetrical and Gynecological Survey.

[8]  J. E. Dunn,et al.  Morphogenesis of cervical cancer. Findings from San Diego County Cytology Registry , 1967, Cancer.

[9]  J. H. Pearson Cervical cancer screening programs. , 1983, Canadian Medical Association journal.

[10]  R. Richart,et al.  Statistical model of the natural history of cervical carcinoma. II. Estimates of the transition time from dysplasia to carcinoma in situ. , 1970, Journal of the National Cancer Institute.

[11]  T. Louis,et al.  Screening for the early detection of cancer— I. The temporal natural history of a progressive disease state , 1978 .

[12]  W. Chow,et al.  Decline in the incidence of carcinoma in situ of the cervix. , 1986, American journal of public health.

[13]  Young Jl,et al.  SEER Program: cancer incidence and mortality in the United States 1973-81. , 1984 .

[14]  S. Schwartz,et al.  Increased incidence of adenocarcinoma of the cervix in young women in the United States. , 1986, American journal of epidemiology.

[15]  H. Hausen,et al.  A new type of papillomavirus DNA, its presence in genital cancer biopsies and in cell lines derived from cervical cancer. , 1984, The EMBO journal.

[16]  D. Eddy ACS report on the cancer-related health checkup. , 1980, CA: a cancer journal for clinicians.

[17]  R. Richart,et al.  Screening strategies for cervical cancer and cervical intraepithelial neoplasia , 1981, Cancer.

[18]  D. Boyes,et al.  CERVICAL CANCER DETECTION IN BRITISH COLUMBIA , 1968 .