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Int J Cancer. 2018 Oct 24. doi: 10.1002/ijc.31940. [Epub ahead of print]

Cervical Cancer Screening Research in the PROSPR I Consortium: Rationale, Methods, and Baseline Findings from a U.S. Cohort.

Author information

1
Kaiser Permanente Washington Health Research Institute, Seattle, Western Australia.
2
University of Texas Southwestern Medical Center, Dallas, Texas.
3
Simmons Comprehensive Cancer Center, Dallas, Texas.
4
Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Western Australia.
5
Division of Research, Kaiser Permanente Northern California, Oakland, California.
6
University of New Mexico Comprehensive Cancer Center, Albuquerque, New Mexico.
7
Department of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, California.
8
Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
9
UTHealth School of Public Health in Dallas, Dallas, Texas.
10
Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, Maryland.

Abstract

Little is known about the effect of evolving risk-based cervical cancer screening and management guidelines on United States (US) clinical practice and patient outcomes. We describe the National Cancer Institute's Population-based Research Optimizing Screening through Personalized Regimens (PROSPR I) consortium, methods, and baseline findings from its cervical sites: Kaiser Permanente Washington, Kaiser Permanente Northern California, Kaiser Permanente Southern California, Parkland Health & Hospital System/University of Texas Southwestern (Parkland-UTSW), and New Mexico HPV Pap Registry housed by University of New Mexico (UNM-NMHPVPR). Across these diverse healthcare settings, we collected data on human papillomavirus (HPV) vaccinations, screening tests/results, diagnostic and treatment procedures/results, and cancer diagnoses on nearly 4.7 million women aged 18-89 years from 2010 to 2014. We calculated baseline (2012 for UNM-NMHPVPR; 2010 for other sites) frequencies for sociodemographics, cervical cancer risk factors, and key screening process measures for each site's cohort. Healthcare delivery settings, cervical cancer screening strategy, Ethnic group/ethnicity, and insurance status varied among sites. The proportion of women receiving a Pap test during the baseline year was similar across sites (26.1-36.1%). Most high-risk HPV tests were performed either reflexively or as co-tests, and utilization pattern varied by site. Prevalence of colposcopy or biopsy was higher at Parkland-UTSW (3.6%) than other sites (1.3-1.4%). Incident cervical cancer was rare. HPV vaccination among age-eligible women not already immunized was modest across sites (0.1-7.2%). Cervical PROSPR I makes available high-quality, multilevel, longitudinal screening process data from a large and diverse cohort of women to evaluate and improve the effectiveness of US cervical cancer screening delivery. This article is protected by copyright. All rights reserved.

KEYWORDS:

Pap test; cancer screening; cervical cancer; human papillomavirus

PMID:
30353911
DOI:
10.1002/ijc.31940

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