The process of cervical carcinogenesis may take between 10 and 30 years from HPV infection to progression to invasive cancer, and many HPV infections never cause cancer. Thus, it is unclear if cervical cancer represents a threat to older women who face competing causes of mortality, if benefits outweigh harms in this group, and if screening into older age is a reasonable expenditure. Conducting a randomized trial to evaluate the effects of screening older women would not be feasible given the relative rarity of cervical cancer, the length of follow-up needed, and the large sample size required. In this situation, mathematical modeling can simulate population harms, benefits, and costs, and can guide policy decisions. A validated model shows that extending biennial screening with Pap smears and HPV testing from age 65 years to age 75 years would entail an additional 400 000 false-positive results. Biennial screening with Pap smears and for HPV between the ages of 20 and 65 years captures 86.6% of the benefits of lifetime
Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more
Subscribe for full-text access to content from 1998 forward and a host of useful features
Activate your current subscription (AMA members and current subscribers)
Purchase Online Access to this article for 24 hours
Costs and outcomes of biennial Papanicolaou test and human papillomavirus screening by age at screening cessation. The left-hand axis displays the incremental costs of screening and the right-hand axis shows the incremental quality-adjusted life-days (QALDs) saved using biennial screening with Papanicolaou and human papillomavirus testing, compared with biennial Papanicolaou screening alone.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
Instructions
Thank you for submitting a comment on this article. It will be reviewed by JAMA Internal Medicine editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest* Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 10
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Users' Guides to the Medical Literature Are the Treatment Benefits Worth the Risks and Costs?
Users' Guides to the Medical Literature Trading Off Benefits, Risks, and Costs
All results at JAMAevidence.com >
and access these and other features:
Register Now
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Need assistance?
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.