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Eligibility for cervical cancer screening exit: Comparison of a national and safety net cohort.
- Source :
-
Gynecologic oncology [Gynecol Oncol] 2021 Aug; Vol. 162 (2), pp. 308-314. Date of Electronic Publication: 2021 Jun 03. - Publication Year :
- 2021
-
Abstract
- Objective: To determine eligibility for discontinuation of cervical cancer screening.<br />Methods: Women aged 64 with employer-sponsored insurance enrolled in a national database between 2016 and 2018, and those aged 64-66 receiving primary care at a safety net health center in 2019 were included. Patients were evaluated for screening exit eligibility by current guidelines: no evidence of cervical cancer or HIV-positive status and no evidence of cervical precancer in the past 25 years, and had evidence of either hysterectomy with removal of the cervix or evidence of fulfilling screening exit criteria, defined as two HPV screening tests or HPV plus Pap co-tests or three Pap tests within the past 10 years without evidence of an abnormal result.<br />Results: Of the 590,901 women in the national claims database, 131,059 (22.2%) were eligible to exit due to hysterectomy (1.6%) or negative screening (20.6%). Of the 1544 women from the safety net health center, 528 (34.2%) were eligible to exit due to hysterectomy (9.3%) or negative screening (24.9%). Most women did not have sufficient data available to fulfill exit criteria: 382,509 (64.7%) in the national database and 875 (56.7%) in the safety net hospital system. Even among women with 10 years of insurance claims data, only 41.5% qualified to discontinue screening.<br />Conclusions: Examining insurance claims in a national database and electronic medical records at a safety net institution led to remarkably similar findings: two thirds of women fail to qualify for screening exit. Additional steps to ensure eligibility prior to screening exit may be necessary to decrease preventable cervical cancers among women aged >65.<br />Clinical Trial Registration: N/A.<br />Competing Interests: Declaration of Competing Interest None<br /> (Copyright © 2021. Published by Elsevier Inc.)
- Subjects :
- Administrative Claims, Healthcare statistics & numerical data
Aged
Cohort Studies
Early Detection of Cancer statistics & numerical data
Electronic Health Records statistics & numerical data
Eligibility Determination statistics & numerical data
Female
Humans
Hysterectomy statistics & numerical data
Insurance Coverage standards
Insurance Coverage statistics & numerical data
Middle Aged
Papanicolaou Test statistics & numerical data
Papillomavirus Infections pathology
Papillomavirus Infections virology
Practice Guidelines as Topic
Safety-net Providers standards
Safety-net Providers statistics & numerical data
United States
Uterine Cervical Neoplasms pathology
Uterine Cervical Neoplasms prevention & control
Uterine Cervical Neoplasms virology
Vaginal Smears statistics & numerical data
Early Detection of Cancer standards
Eligibility Determination standards
Papillomavirus Infections diagnosis
Uterine Cervical Neoplasms diagnosis
Subjects
Details
- Language :
- English
- ISSN :
- 1095-6859
- Volume :
- 162
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Gynecologic oncology
- Publication Type :
- Academic Journal
- Accession number :
- 34090706
- Full Text :
- https://doi.org/10.1016/j.ygyno.2021.05.035