Evidence map›Paper›PMID 41001228›Full record

ArticleO&G open2024

Accessibility of Criteria to Exit Cervical Cancer Screening at Age 65 Years in the Electronic Health Record.

Stephanie Alimena, Jacquelyn M Lykken, Jasmin A Tiro, Jessica Chubak, Jennifer S Haas, Claudia Werner, Sarah C Kobrin, Michelle I Silver, Rebecca B Perkins, Sarah Feldman

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in O&G open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Article
  3. 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.

Stephanie AlimenaDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Jacquelyn M LykkenDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Jasmin A TiroDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Jessica ChubakDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Jennifer S HaasDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Claudia WernerDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Sarah C KobrinDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Michelle I SilverDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Rebecca B PerkinsDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.
Sarah FeldmanDivision of Gynecologic Oncology, Brigham and Women's Hospital, Harvard Medical School, the Division of General Internal Medicine, Massachusetts General Hospital, Harvard Medical School, the Department of Obstetrics and Gynecology, Boston Medical Center, and Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts; the Peter O'Donnell Jr. School of Public Health and the Department of Obstetrics and Gynecology, University of Texas Southwestern Medical Center, and Parkland Health and Hospital System, Dallas, Texas; the Department of Public Health Sciences, University of Chicago Biological Sciences Division, Chicago, Illinois; Kaiser Permanente Washington Health Research Institute, Seattle, Washington; the Department of Surgery, Washington University School of Medicine in St. Louis, St. Louis, Missouri; and the Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo describe the proportion of patients with documentation of meeting cervical cancer screening exit criteria in the medical record and to estimate the incidence of cancer and high-grade precancerous lesions after age 65 years detected by the end of the study period, by screening exit eligibility.

methodsWe conducted a retrospective analysis of patients who turned 66 years old between 2010 and 2019 at two large health care systems located in Dallas, Texas, and Boston, Massachusetts, from the METRICS (MultilEvel opTimization of the ceRvIcal Cancer Screening process in diverse Settings & populations) Research Center, part of the PROSPR II (Population-based Research to Optimize the Screening Process) consortium. The primary outcomes were 1) the percentage of patients who were eligible for screening exit at age 66 years after adequate documented negative screening history (at least three consecutive negative cytology test results or two consecutive negative human papillomavirus [HPV] test or co-test results [cytology+HPV testing] within the prior 10 years) and 2) the worst pathology or cytology outcome documented in the cohort after age 65 years.

resultsAmong 42,393 people who turned 66 years old while in the METRICS cohort, approximately 75.7% (n=32,094) were not eligible to exit screening at age 66 years, primarily because too few screening tests were documented (n=29,354, 91.5% of those ineligible). Furthermore, only 4,037 patients at both sites had 10 years of prior observation within the health care system, meaning data from current and prior health care delivery sites would be needed to assess exit eligibility for more than 90% of the cohort. Patients remained in the cohort after their 66th birthday on average for 3.8 years (interquartile range 2.0-6.5 years), and most (79.3%) had no subsequent evaluation after their 66

conclusionData documented in the medical record are often insufficient to meet guidelines for exiting cervical cancer screening.

Identifiers

PMID41001228
PMCPMC12456487

What OpenQuestion holds

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LicenceCC BY-NC-ND
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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.