Cervical screening: time to change the policy

@article{Dickinson2002CervicalST,
  title={Cervical screening: time to change the policy},
  author={James A. Dickinson},
  journal={Medical Journal of Australia},
  year={2002},
  volume={176}
}
  • J. Dickinson
  • Published 1 June 2002
  • Medicine, Political Science
  • Medical Journal of Australia
In 1991, the “organised approach to preventing cancer of the cervix” recommended Pap smears every two years for women aged 18–70 years who have ever been sexually active. The two‐year interval was a compromise step towards the scientifically supported three‐year interval, as many influential groups were strongly attached to annual screening. When other components of the organised approach were in place, the policy was to be reviewed. Since the safeguards in the “organised approach” have been… 
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References

SHOWING 1-10 OF 41 REFERENCES
Recommendations for cervical screening 1997. Members of the Working Party on Cervical Screening.
  • Medicine
    The New Zealand medical journal
  • 1998
TLDR
A working group to review the 1991 recommendations on cervical screening in New Zealand suggested no major changes have been suggested but minor modifications have been made with regard to recent literature.
Is cervical cytology screening of teenagers worthwhile?
  • S. Ford
  • Medicine
    British journal of obstetrics and gynaecology
  • 1996
TLDR
The author’s own approach is changing in an attempt to facilitate access to contraceptive care for young people by downplaying the most unwelcome element: pelvic examination and smear.
Evaluation of a mass-media-led campaign to increase Pap smear screening.
TLDR
Although the campaign appears to have prompted short-term increases in screening rates, the effect is too small to make a substantial impact on the size of the under-screened population.
Trends in Invasive Cervical Cancer Incidence in East Anglia from 1971 to 1993
TLDR
Since 1990, rates have fallen sharply in the age groups targeted for screening, with a reduction of 34% (95% confidence interval 26% to 42%) from that expected based on 1971–90 trends.
Consequences of Current Patterns of Pap Smear and Colposcopy Use
TLDR
Many more women will have colposcopy than will develop cervical cancer, which undermines the cost effectiveness of Australia's cervical cancer screening programme.
Effect of screening on cervical cancer mortality in England and Wales: analysis of trends with an age period cohort model
The number of women dying from cervical cancer in 1997 was 7% lower than in 1996 and has fallen by over 25% since 1992.1 Such rapid change must be at least partly due to cervical screening, although
The Mildly Abnormal Cervical Smear: Patient Anxiety and Choice of Management
TLDR
Whatever the relative merits of these two strategies for clinical management, it is clear that both forms of screening, and especially colposcopy, demand better information for patients.
Duration of preclinical cervical cancer and reduction in incidence of invasive cancer following negative pap smears.
TLDR
The apparent contradiction between model estimates and observed data is explained by recognizing that many of the women who have had negative smears will have further Pap smears, resulting in earlier diagnosis of invasive cervical cancers and thus an apparent faster build-up of the incidence.
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