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Obstetrics & Gynecology 2004;103:564-571
© 2004 by The American College of Obstetricians and Gynecologists
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ORIGINAL RESEARCH

Cervical Screening in the National Breast and Cervical Cancer Early Detection Program, 1995–2001

Vicki B. Benard, PhD, Christie R. Eheman, PhD, Herschel W. Lawson, MD, Donald K. Blackman, PhD, Christa Anderson, William Helsel, MS, Sandra F. Thames and Nancy C. Lee, MD

From the Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Atlanta, Georgia; and Information Management Services, Inc, Silver Spring, Maryland.

Address reprint requests to: Vicki B. Benard, PhD, Epidemiology and Health Services Research Branch, Division of Cancer Prevention and Control, Mailstop K-55, NCCDPHP, CDC, 4770 Buford Highway NE, Atlanta, GA 30341; e-mail: vdb9{at}cdc.gov.

OBJECTIVE: To describe results of cervical cytology screening among low-income and uninsured women in the National Breast and Cervical Cancer Early Detection Program.

METHODS: We analyzed data from 750,591 women who received their first Papanicolaou (Pap) test in the program between July 1995 and March 2001.

RESULTS: Nearly 85% of the women were aged 40 years or older. Almost half were members of racial or ethnic minority groups. Overall, the percentage of abnormal Pap test results decreased with increasing age. The rates of cervical intraepithelial neoplasia (CIN) were highest in the younger age groups but the rate of invasive cancer increased with age. White women had the highest age-adjusted percentage of abnormal Pap test results and the highest rate of biopsy-confirmed CIN 2 or worse.

CONCLUSIONS: In this nationwide screening program, only 7% of all biopsy-confirmed high-grade cervical lesions (CIN 2 or worse) were invasive cancer. This underscores the success of Pap screening in identifying preinvasive disease and preventing cancer.

LEVEL OF EVIDENCE: II-3






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