218716 Timing of cervical cancer diagnosis and treatment in the National Breast and Cervical Cancer Early Detection Program

Monday, November 8, 2010

Vicki Benard, PhD , Division of Cancer Prevention and Control, Center for Disease Control and Prevention, Atlanta, GA
Will Howe, MS , Information Management Services, Inc., Silver Spring, MD
Janet Royalty, MS , Division of Cancer Prevention and Control, Center for Disease Control and Prevention, Atlanta, GA
William Kammerer, MS , Information Management Services, Inc., Silver Spring, MD
William Helsel, MS , Information Management Services, Inc., Silver Spring, MD
Lisa Richardson, MD , Division of Cancer Prevention and Control, Center for Disease Control and Prevention, Atlanta, GA
  
Purpose: To examine time intervals from cervical cancer screening, diagnosis and treatment among low income and uninsured women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) Methods: We examined diagnostic and treatment intervals for the time periods of 1996-2001 and 2002-2007 to evaluate program effectiveness. The intervals were defined as: (1) time between Pap test and diagnosis for all women receiving an abnormal Pap result (including low-grade squamous intraepithelial, high-grade squamous intraepithelial, and squamous cancer) and (2) time between diagnosis and treatment among those diagnosed with high-grade cervical intraepithelial neoplasia (CIN2, CIN3, Carcinoma in situ) or invasive cervical cancer. Results: For the entire study period, 83, 206 women screened for cervical cancer had abnormal screen results for which 22,958 high-grade CIN and 1,134 invasive cervical cancers were diagnosed. Median diagnostic intervals decreased by 4 days (54 vs. 50); the number of days decreased with severity in Pap test result for both time periods. Median treatment initiation intervals for high-grade CIN increased by 3 days (25 vs 28). Median treatment initiation intervals for invasive cervical cancer decreased by 2 days (22 vs. 20). Using data from the most recent time period, 86% of women diagnosed with invasive cervical cancer initiated treatment within the program benchmark of 120 days of the abnormal screening test. Summary: The goal of the NBCCEDP is to ensure that women receive quality screening, timely diagnostic services and treatment. Our data show that the program is meeting these goals and may provide useful benchmarks.

Learning Areas:
Chronic disease management and prevention
Provision of health care to the public
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
To evaluate the time intervals from cervical cancer screening, to diagnosis and to treatment initiation among low income and uninsured women who participate in the National Breast and Cervical Early Detection Program

Keywords: Cancer Screening, Low-Income

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an epidemiologist at CDC working with the National Breast and Cervcial Cancer Early Detection Program
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 3081.4: Cancer Prevention and Control: Interpersonal, Community, and Population Perspectives