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JNCI Journal of the National Cancer Institute 2006 98(2):82-83; doi:10.1093/jnci/djj035
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© The Author 2006. Published by Oxford University Press.

EDITORIAL

Human Papillomavirus Triage of Atypical Squamous Cells of Undetermined Significance: Cost-Effective, But At What Cost?

Joy Melnikow, Stephen Birch

Affiliations of authors: Department of Family and Community Medicine, University of California–Davis, Sacramento, CA (JM); Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada (SB)

Correspondence to: Joy Melnikow, MD, MPH, Department of Family and Community Medicine, 4860 Y St., Ste. 2300, Sacramento, CA 95817 (e-mail: jamelnikow@ucdavis.edu).

The first 10% of the full text of this article appears below.

Since the introduction of cytology for cervical cancer screening more than 50 years ago, deaths from cervical cancer in the United States have declined by about 75% (1). However, an estimated 3700 women will die from cervical cancer in the United States in 2005 (2). Among the 55 million Pap smears performed in the United States annually, roughly 3 million show atypical cells of undetermined significance (ASCUS), a conundrum for pathologists, clinicians, and patients (3).

Great strides have been made in understanding the underlying biology of cervical cancer. Infection with an oncogenic human papillomavirus (HPV) is necessary but not sufficient for its development. Recent research has attempted to improve the sensitivity of cervical cancer screening to reduce false-negative tests and hence prevent . . . [Full Text of this Article]


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