Increasing Pap screening adherence and improving the accuracy of Pap screening could reduce the incidence of invasive cervical cancer among women with access to screening and could afford earlier detection of cervical cancer, a new study concludes.

Cervical cancer is highly preventable and treatable. Therefore, the occurrence of an invasive cervical cancer represents a failure in the screening process. To elucidate factors associated with screening failure, Wendy A. Leyden, of Kaiser Permanente in Oakland, Calif., and colleagues examined the medical records of 833 women enrolled in one of seven comprehensive health care plans who were diagnosed with cervical cancer despite having access to cancer screening and treatment services.

They found that 56% of cases were in women who had not had a Pap test during the period 4 to 36 months prior to diagnosis, whereas 32% of cases were attributed to Pap test detection failure and 13% of cases to failure to follow up an abnormal test result. Most (81%) of the women with no Pap screening had had at least one unrelated outpatient visit 4 to 36 months prior to their cancer diagnosis.

"Despite the many exciting new technologies that may improve our ability to predict or detect cervical neoplasia, we must not lose sight of the need to increase screening adherence," the authors write. "Even the most perfect screening method will not detect disease in a woman who has not participated in the prevention process."

Contact: Laura H. Marshall, Kaiser Permanente, Laura.H.Marshall@kp.org, 510-271-5826

Survival Not Improved With Dose-Dense Chemotherapy for Small-Cell Lung Cancer

A randomized trial has found that a dose-dense regimen of chemotherapy with blood progenitor cell support did not improve survival compared with standard-dose chemot
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Contact: Sarah L. Zielinski
jncimedia@oupjournals.org
301-841-1287
Journal of the National Cancer Institute
3-May-2005