Evidence map›Paper›PMID 38652505›Full record

ArticleCancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology2024

Assessing Management of Abnormal Cervical Cancer Screening Results and Concordance with Guideline Recommendations in Three US Healthcare Settings.

David Cheng, Meghan L Rieu-Werden, Jacquelyn M Lykken, Claudia L Werner, Sarah Feldman, Michelle I Silver, Steven J Atlas, Jasmin A Tiro, Jennifer S Haas, Aruna Kamineni

Open access · greenAbstract read
In one paragraph

Article in Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
0.4field-weighted citation impact, top 39% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 citations in OpenAlex.

  1. Article
  2. Characterizing Cervical Cancer Screening in the US: Preparing for the Era of Self-Collection.Journal of the American Board of Family Medicine : JABFM · 2026
    Article
  3. Process Mapping to Compare and Improve Management of Abnormal Cervical Cancer Screening Results in Two US Healthcare Systems within the PROSPR Consortium.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2025
    Article
  4. Observational
  5. Individual and Geographical Factors Associated With Follow-Up Care After an Abnormal Cervical Cancer Screening Result.Women's health issues : official publication of the Jacobs Institute of Women's Health
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 7 institutions in 1 country.

David ChengBiostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0002-2816-6585
Meghan L Rieu-WerdenDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0009-0002-1235-4167
Jacquelyn M LykkenPeter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, Texas.ORCID 0000-0003-0872-0873
Claudia L WernerDepartment of Obstetrics and Gynecology, University of Southwestern Medical Center, Dallas, Texas.ORCID 0000-0003-0457-5269
Sarah FeldmanDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0002-5582-9401
Michelle I SilverDivision of Public Health Sciences, Department of Surgery, Washington University School of Medicine, St Louis, Missouri.ORCID 0000-0002-2678-3539
Steven J AtlasDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0002-2297-9614
Jasmin A TiroDepartment of Public Health Sciences, University of Chicago-Biological Sciences Division, Chicago, Illinois.ORCID 0000-0001-8300-0441
Jennifer S HaasDivision of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.ORCID 0000-0001-7227-851X
Aruna KamineniKaiser Permanente Washington Health Research Institute, Seattle, Washington.ORCID 0000-0002-0763-989X
Harvard University · USBrigham and Women's Hospital · USChicago Department of Public Health · USKaiser Permanente Washington Health Research Institute · USParkland Health & Hospital System · USThe University of Texas Southwestern Medical Center · USWashington University in St. Louis · US

Funding

PROSPR METRICS CISNET Collaboration Investigating Impact of Structural Racism/Discrimination on Cervical Screening Moonshot SupplementUM1CA221940 · NCI · UT SOUTHWESTERN MEDICAL CENTER · PI CHUBAK, JESSICA, HAAS, JENNIFER S · 2018 to 2023
$15.9M
American Cancer Society (ACS) CRP-22-080-01-CTPSNational Cancer Institute (NCI) UM1CA221940NCI NIH HHS UM1 CA221940
6 · The paper itself

Abstract

backgroundFollow-up of abnormal results is essential to cervical cancer screening, but data on adherence to follow-up are limited. We describe patterns of follow-up after screening abnormalities and identify predictors of guideline-concordant follow-up.

methodsWe identified the index screening abnormality (positive human papillomavirus test or atypical squamous cells of undetermined significance or more severe cytology) among women of ages 25 to 65 years at three US healthcare systems during 2010 to 2019. We estimated the cumulative incidence of surveillance testing, colposcopy, or treatment after the index abnormality and initial colposcopy. Logistic regressions were fit to identify predictors of guideline-concordant follow-up according to contemporaneous guidelines.

resultsAmong 43,007 patients with an index abnormality, the cumulative incidence of any follow-up was 49.6% by 4 years for those with atypical squamous cells of undetermined significance/human papillomavirus-negative and higher for abnormalities warranting immediate colposcopy. The 1-year cumulative incidence of any follow-up after colposcopy was 70% for patients with normal results or cervical intraepithelial neoplasia I and 90% for patients with cervical intraepithelial neoplasia II+. Rates of concordant follow-up after screening and colposcopy were 52% and 47%, respectively. Discordant follow-up was associated with factors including age, race/ethnicity, overweight/obese body mass index, and specific types of public payor coverage or being uninsured.

conclusionsAdherence to the recommended follow-up of cytologic and histopathologic abnormalities is inconsistent in clinical practice. Concordance was poor for mild abnormalities and improved, although suboptimal, for more severe abnormalities. IMPACT: There remain gaps in the cervical cancer screening process in clinical practice. Further study is needed to understand the barriers to the appropriate management of cervical abnormalities.

Indexed as

ColposcopyEarly Detection of CancerUterine Cervical NeoplasmsAdultAgedFemaleGuideline AdherenceHumansMiddle AgedPapillomavirus InfectionsPractice Guidelines as TopicUnited States

Identifiers

PMID38652505
PMCPMC11366420
OpenAlexW4395032765

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.