© 2004 by Oxford University Press
© 2004 Oxford University Press
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In Brief
Many Women Who Lack Cervix Being Screened for Cervical Cancer
A new study estimates that nearly half of all women who have undergone a hysterectomy, including removal of their cervix, are being screened unnecessarily for cervical cancer.
In 1996, the U.S. Preventive Services Task Force advised that screening women who have had a hysterectomy for benign disease is unnecessary. To evaluate whether the task force's recommendation had an effect on screening practices, researchers looked at the answers from 187,670 women surveyed as part of the Behavioral Risk Factor Surveillance System between 1992 and 2002 who reported having a hysterectomy.
According to the survey, nearly 70% of these women reported having a Pap smear in the past 3 years both in 1992, before the task force's recommendation, and in 2002, 6 years after the recommendation. After accounting for hysterectomies that occurred after screening and those that may have spared the cervix or were performed for cervical neoplasia, the authors estimated that 10 million women, or nearly half of women who have had a hysterectomy, are being screened unnecessarily for cervical cancer.
Women who have had hysterectomies may not be aware that they are not at risk for cervical cancer, or they may simply be enthusiastic about cancer screening, the authors suggested. In addition, physicians may be encouraging all women, whether or not they have a cervix, to be screened. The study was published in the June 23/30 issue of the Journal of the American Medical Association.
Report Shows Increase in Cancer Survivors
A new report on cancer survivorship from the Centers for Disease Control and Prevention (CDC) and the National Cancer Institute (NCI) has found that the number of cancer survivors in the United States has increased from 3.0 million (1.5% of the population) in 1971 to 9.8 million (3.5%) in 2001. A cancer survivor is defined as anyone who has been diagnosed with cancer during his or her lifetime.
The report also found that 64% of adults diagnosed with cancer during 1995–2001 could expect to live at least 5 years, compared with only 50% of adults diagnosed during 1974–76. A national health objective has set a goal of increasing the proportion of cancer patients who survive 5 or more years to 70% by 2010.
The report attributes the increase in survival to increased screening resulting in earlier diagnoses, more effective treatments, prevention of cancer recurrence and secondary diseases, and decreases in mortality from other causes. However, the authors of the report also cautioned that higher survival rates do not necessarily mean that fewer people are dying from cancer or that cancer management has improved. The report was published in the June 25 issue of Morbidity and Mortality Weekly Report.
British Health Service Issues Guidelines on Familial Breast Cancer
The National Institute for Clinical Excellence, the organization responsible for providing guidance to the National Health Service in England and Wales, has issued new guidelines to help identify and treat women at risk of familial breast cancer.
To better identify women who have a higher risk of breast cancer, the guidelines recommend that physicians take a family history but limit genetic testing only to those who are from high-risk families. Mammography should be offered to women only after they have been given appropriate information about its advantages and disadvantages, according to the new guidelines.
The guidelines also highlight the need for better communication of the risks for developing breast cancer to all women and recommend offering women standard written information to provide consistent advice.
Although local health communities are not required to implement all of the guidelines, it is recommended that they review their existing management of familial breast cancer against the new guidelines and revise their practices accordingly.
The new guidelines are available online from the National Institute for Clinical Excellence at http://www.nice.org.uk/page.aspx?o=203181.
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