TY - JOUR
T1 - Risk assessment to guide the prevention of cervical cancer
AU - Castle, Philip E.
AU - Sideri, Mario
AU - Jeronimo, Jose
AU - Solomon, Diane
AU - Schiffman, Mark
N1 - Funding Information:
This work was supported by the Intramural Research Program of the National Institutes of Health, National Cancer Institute. The financial activities of P.E.C., J.J., D.S., and M.S. are monitored by the National Cancer Institute Ethics Office.
PY - 2008/1
Y1 - 2008/1
N2 - Advances in screening and diagnosis make it increasingly possible to prevent cervical cancer. However, if misused or poorly understood, these new tools will only increase costs and potentially harm patients without benefit. As a framework for standardized care that maximizes patient safety and well-being, we propose that a risk model be adopted to guide clinical management now and in the future. The model would use thresholds of increasing risk for cervical precancer and treatable cancer to guide clinical decision making for screening intensity, diagnostic evaluation, or treatment. Experts would decide on these risk thresholds and stratum based on the patient risk to benefit, independent of current (e.g., cytology, carcinogenic human papillomavirus testing, and colposcopy) and future methods of measuring risk. A risk management model for cervical cancer prevention, based on appropriate clinical actions that correspond to risk stratum, can result in better allocation of resources to and increased safety for women at the greatest risk and increased well-being for women at the lowest risk.
AB - Advances in screening and diagnosis make it increasingly possible to prevent cervical cancer. However, if misused or poorly understood, these new tools will only increase costs and potentially harm patients without benefit. As a framework for standardized care that maximizes patient safety and well-being, we propose that a risk model be adopted to guide clinical management now and in the future. The model would use thresholds of increasing risk for cervical precancer and treatable cancer to guide clinical decision making for screening intensity, diagnostic evaluation, or treatment. Experts would decide on these risk thresholds and stratum based on the patient risk to benefit, independent of current (e.g., cytology, carcinogenic human papillomavirus testing, and colposcopy) and future methods of measuring risk. A risk management model for cervical cancer prevention, based on appropriate clinical actions that correspond to risk stratum, can result in better allocation of resources to and increased safety for women at the greatest risk and increased well-being for women at the lowest risk.
KW - Cervical cancer
KW - Cervical cytology
KW - Cervical precancer
KW - Human papillomavirus
KW - Risk
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U2 - 10.1097/lgt.0b013e31815ea58b
DO - 10.1097/lgt.0b013e31815ea58b
M3 - Review article
C2 - 18162804
AN - SCOPUS:37549029230
SN - 1089-2591
VL - 12
SP - 1
EP - 7
JO - Journal of lower genital tract disease
JF - Journal of lower genital tract disease
IS - 1
ER -