HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Miller, M. G. Articles by Hiatt, R. A. Search for Related Content PubMed PubMed Citation Articles by Miller, M. G. Articles by Hiatt, R. A.

Screening Interval and Risk of Invasive Squamous Cell Cervical Cancer

From the Department of Quality and Utilization and Division of Research, Kaiser Permanente Medical Care Program, Oakland, California; Division of Gynecologic Oncology, Kaiser Permanente Medical Care Program, Sacramento, California; Institute for Health and Aging, School of Nursing, and Departments of Obstetrics, Gynecology, & Reproductive Sciences and Epidemiology and Biostatistics, University of California, San Francisco, California.

Address reprint requests to: Marie Grisham Miller, PhD, 2331 Rancho del Lago Road, Martinez, CA 94553; E-mail: mariegmiller{at}saber.net.

OBJECTIVE: To compare the risks of developing invasive squamous cell cervical cancer associated with screening intervals of 1, 2, and 3 years after a negative cervical smear.

METHODS: We conducted a matched case-control study of invasive squamous cell cervical cancer patients (n = 482) diagnosed between 1983 and 1995 among long-term members of a large health maintenance organization. Controls were matched for age, length of membership, and race (n = 934). Screening interval was time between the last negative cervical smear and the case diagnosis date. The main outcome measure was the relative odds of invasive disease associated with 1-year, 2-year, and 3-year intervals.

RESULTS: The odds ratio for a 2-year versus a 1-year interval was 1.72 (95% confidence interval 1.12, 2.64, P = .013) and for a 3-year versus a 1-year interval was 2.06 (95% confidence interval 1.21, 3.50, P = .007). The odds ratio for a 3-year versus a 2-year interval was 1.20 (95% confidence interval 0.65, 2.21, P = .561). Controlling for ever having had an abnormal cervical smear or a previous consecutive negative smear did not substantially change these results.

CONCLUSION: In this large health plan, the relative risks of invasive squamous cell cervical cancer were significantly greater for 2-year and 3-year cervical cancer screening intervals compared with a 1-year interval, but not for a 3-year interval compared with a 2-year interval. Our findings need to be placed in the context of the low absolute risks of developing invasive cervical cancer during the first 3 years after a negative cervical smear before making policy recommendation.

This article has been cited by other articles:

				R. Insinga and M. G. Miller Screening Interval and Risk of Invasive Squamous Cell Cervical Cancer Obstet. Gynecol., July 1, 2003; 102(1): 199 - 200. [Full Text] [PDF]

				N. Pisal, M. Sindos, A. Singer, M. G. Miller, R. A. Hiatt, G. F. Sawaya, and H.-Y. Sung Screening Interval and Risk of Invasive Squamous Cell Cervical Cancer Obstet. Gynecol., May 1, 2003; 101(5): 1021 - 1022. [Full Text] [PDF]