Evidence map›Paper›PMID 39197415›Full record

ArticleGynecologic oncology2024

Impact of management guidelines for abnormal cervical cytology on colposcopy procedure rates among young women.

Narissa J Nonzee, Heike Thiel de Bocanegra, Sandy Navarro, Roshan Bastani, Beth A Glenn, Gerald F Kominski, Anna-Barbara Moscicki

Abstract read
In one paragraph

Article in Gynecologic oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. 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

7 authors.

Narissa J NonzeeDivision of Health Equities, Department of Population Sciences, City of Hope, Duarte, California, USA. Electronic address: nnonzee@coh.org.
Heike Thiel de BocanegraDepartment of Obstetrics and Gynecology, University of California, Irvine, California, USA. Electronic address: hthiel@hs.uci.edu.
Sandy NavarroBixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, CA, USA.
Roshan BastaniUCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, California, USA. Electronic address: bastani@ucla.edu.
Beth A GlennUCLA Center for Cancer Prevention and Control Research, UCLA Kaiser Permanente Center for Health Equity, Department of Health Policy and Management, Fielding School of Public Health and Jonsson Comprehensive Cancer Center, University of California Los Angeles, California, USA. Electronic address: bglenn@ucla.edu.
Gerald F KominskiUCLA Center for Health Policy Research and Department of Health Policy and Management, UCLA Fielding School of Public Health, Los Angeles, California, USA. Electronic address: kominski@ucla.edu.
Anna-Barbara MoscickiDivision of Adolescent and Young Adult Medicine, Department of Pediatrics, University of California, Los Angeles, California, USA. Electronic address: AMoscicki@mednet.ucla.edu.

Funding

Transgenic Mouse FacilityP30CA033572 · NCI · CITY OF HOPE/BECKMAN RESEARCH INSTITUTE · PI STANLEY R. HAMILTON · 1985 to 2026
$86.3M
NRSA Training CoreTL1TR001883 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI ALEX BUI, Nina Thawata Harawa · 2016 to 2026
$8.6M
UCLA Clinical and Translational Science InstituteTL1TR000121 · NCATS · UNIVERSITY OF CALIFORNIA LOS ANGELES · PI DUBINETT, STEVEN M. · 2012 to 2015
$2.7M
AHRQ HHS T32 HS000046NCATS NIH HHS TL1 TR000121NCATS NIH HHS TL1 TR001883NCI NIH HHS P30 CA033572
6 · The paper itself

Abstract

objectiveIn 2012, updated ASCCP management guidelines for abnormal cervical cytology recommended observation rather than immediate referral to colposcopy for low-grade abnormalities in women ages 21-24. We evaluated the impact of these guidelines on changes in colposcopy procedure rates among young women.

methodsWe analyzed administrative and claims data from the largest statewide family planning program between July 2011 and June 2015. Using a difference-in-differences approach, we estimated changes in colposcopy procedure rates among women ages 21-24 years before and after the 2012 ASCCP management guidelines, relative to a comparison group of women ages 25-44.

resultsOur analysis included 333,977 women from 216 primary care provider sites. After publication of the 2012 ASCCP management guidelines, colposcopy rates significantly declined from 6.70% (95% CI 6.21-7.19) to 3.94% (95% CI 3.60-4.29) among women ages 21-24 and from 4.35% (95% CI 4.03-4.67) to 3.53% (3.25-3.80) among women over 24 years. These declines correspond to a 1.93 percentage point reduction (95% CI 1.62-2.25; p < 0.001) in colposcopy rate among women 21-24 vs. over 24 years, or a two-fold relative reduction. Among women ages 21-24, colposcopy receipt was associated with speaking primarily English vs. non-English (OR 1.46, 95% CI 1.35-1.57), having a cervical cytology test within the past year vs. not (OR 1.55, 95% CI 1.44-1.66), and receiving care from a public vs. private provider (OR 1.31, 95% CI 1.06-1.62).

conclusionsColposcopy procedure rates among young women significantly declined following publication of the 2012 management guidelines, which has implications for reducing potential harms of overtreatment.

Indexed as

ColposcopyPractice Guidelines as TopicUterine Cervical NeoplasmsAdultCervix UteriFemaleHumansUterine Cervical DysplasiaVaginal SmearsYoung AdultCervical cancerColposcopyScreening and managementYoung women

Identifiers

PMID39197415
PMCPMC12248225

What OpenQuestion holds

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Registered trials

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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.