Withdrawing low risk women from cervical screening programmes : mathematical modelling study.
Objective To evaluate the impact of policies for removing women before the recommended age of 64 from screening programmes for, cervical cancer in the United Kingdom.
Design A mathematical model of the clinical course of precancerous lesions which accounts for the influence of infection with the human papillomavirus, the effects of screening on the progression of disease, and the accuracy of the testing procedures.
Two policies are compared : one in which women are withdrawn from the programme if their current smear is negative and they have a recent history of regular, negative results and one in which women are withdrawn if their current smear test is negative and a simultaneous test is negative for exposure to high risk types of human papillomavirus.
Setting United Kingdom cervical screening programme.
Main outcome measures The incidence of invasive cervical cancer and the use of resources.
Results Early withdrawal of selected women from the programme is predicted to give rise to resource savings of up to 25% for smear tests and 18% for colposcopies when withdrawal occurs from age 50, the youngest age considered in the study An increase in the incidence of invasive cervical cancer, by up to 2 cases/100 000 women each year is predicted.
Testing for human papillomavirus infection to determine which women should be withdrawn from the programme makes little difference to outcome. (...)
Mots-clés Pascal : Tumeur maligne, Col utérus, Homme, Femelle, Royaume Uni, Europe, Epidémiologie, Dépistage, Sélection groupe, Facteur risque, Virose, Infection, Papillomavirus, Papovaviridae, Virus, Méthodologie, Programme sanitaire, Modèle mathématique, Appareil génital femelle pathologie, Col utérus pathologie
Mots-clés Pascal anglais : Malignant tumor, Uterine cervix, Human, Female, United Kingdom, Europe, Epidemiology, Medical screening, Group selection, Risk factor, Viral disease, Infection, Papillomavirus, Papovaviridae, Virus, Methodology, Sanitary program, Mathematical model, Female genital diseases, Uterine cervix diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0148748
Code Inist : 002B30A01A1. Création : 16/11/1999.