ArticleBMJ (Clinical research ed.)1999
Withdrawing low risk women from cervical screening programmes: mathematical modelling study.
Article in BMJ (Clinical research ed.), 1999. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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.
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.
Who cites it
12 citing papers in PubMed, 49 citations in OpenAlex.
- Risk of cervical abnormality after age 50 in women with previously negative smears.British journal of cancer · 2009Article
- Calibration methods used in cancer simulation models and suggested reporting guidelines.PharmacoEconomics · 2009Review
- Do women >or=50 years of age need as much screening as women <50 years after they have had negative screening results?British journal of cancer · 2008Article
- Challenging the role of calibration, validation and sensitivity analysis in relation to models of health care processes.Health care management science · 2008Article
- Estimating the long-term impact of a prophylactic human papillomavirus 16/18 vaccine on the burden of cervical cancer in the UK.British journal of cancer · 2007Article
- Cervical human papillomavirus screening among older women.Emerging infectious diseases · 2005Article
- Human papillomavirus infection in women who develop high-grade cervical intraepithelial neoplasia or cervical cancer: a case-control study in the UK.British journal of cancer · 2005Article
- The predicted effect of changes in cervical screening practice in the UK: results from a modelling study.British journal of cancer · 2004Article
- An evaluation of liquid-based cytology and human papillomavirus testing within the UK cervical cancer screening programme.British journal of cancer · 2004Article
- How can we develop a cost-effective quality cervical screening programme?The British journal of general practice : the journal of the Royal College of General Practitioners · 2002Review
- Effects of screening on cervical cancer incidence and mortality in New South Wales implied by influences of period of diagnosis and birth cohort.Journal of epidemiology and community health · 2001Article
- Withdrawing low risk women from cervical screening programmes. Conclusions cannot yet be drawn.BMJ (Clinical research ed.) · 1999Article
Corrections and comments
- Commented on by
- Commented on by
Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the impact of policies for removing women before the recommended age of 64 from screening programmes for cervical cancer in the United Kingdom.
designA mathematical model of the clinical course of precancerous lesions which accounts for the influence of infection with the human papillomavirus, the effects of screening on the progression of disease, and the accuracy of the testing procedures. Two policies are compared: one in which women are withdrawn from the programme if their current smear is negative and they have a recent history of regular, negative results and one in which women are withdrawn if their current smear test is negative and a simultaneous test is negative for exposure to high risk types of human papillomavirus.
settingUnited Kingdom cervical screening programme.
main outcome measuresThe incidence of invasive cervical cancer and the use of resources.
resultsEarly withdrawal of selected women from the programme is predicted to give rise to resource savings of up to 25% for smear tests and 18% for colposcopies when withdrawal occurs from age 50, the youngest age considered in the study. An increase in the incidence of invasive cervical cancer, by up to 2 cases/100 000 women each year is predicted. Testing for human papillomavirus infection to determine which women should be withdrawn from the programme makes little difference to outcome.
conclusionsThis model systematically analyses the consequences of screening options using available data and the clinical course of precancerous lesions. If further audit studies confirm the model's forecasts, a policy of early withdrawal might be considered. This would be likely to release substantial resources which could be channelled into other aspects of health care or may be more effectively used within the cervical screening programme to counteract the possible increase in cancer incidence that early withdrawal might bring.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.