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Cost is a barrier to widespread use of liquid-based cytology for cervical cancer screening in Korea.

Chung HH, Kim JW, Kang SB - J. Korean Med. Sci. (2006)

Bottom Line: Over 65% of respondents preferred conventional cytologic screening to liquid-based cytology.Fifty-three percent used the human papillomavirus DNA test as a triage for atypical squamous cells of undetermined significance.Our findings suggest that majority of Korean obstetricians and gynecologists in hospital prefer annual conventional cytologic testing to liquid-based cytology for financial reason.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul, Korea.

ABSTRACT
This study aimed to document current cervical cancer screening practices of physicians in Korea. Questionnaires were distributed to 852 Korean obstetricians and gynecologists, who attended the 91st Conference of the Korean Society of Obstetrics and Gynecology held during May, 2005. Questionnaires were returned by 30.6% (260/852) of the recipients and 254 of these were eligible for analysis. Sixty-seven percent started cervical cancer screening women at age 20, and 65% replied that they would continue annual screening in a 35-yr-old woman with three consecutive normal cytologic tests. Over 65% of respondents preferred conventional cytologic screening to liquid-based cytology. The cost was a major determinant for selecting screening method. Fifty-three percent used the human papillomavirus DNA test as a triage for atypical squamous cells of undetermined significance. Our findings suggest that majority of Korean obstetricians and gynecologists in hospital prefer annual conventional cytologic testing to liquid-based cytology for financial reason.

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Related in: MedlinePlus

Reasons (white chart, cost; black chart, accuracy) for selecting screening method among respondents (p<0.001, Student t test). Over 90% of physicians who preferred liquid-based cytology replied that they selected it for screening method due to higher accuracy than conventional cytology.
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Figure 4: Reasons (white chart, cost; black chart, accuracy) for selecting screening method among respondents (p<0.001, Student t test). Over 90% of physicians who preferred liquid-based cytology replied that they selected it for screening method due to higher accuracy than conventional cytology.

Mentions: Most respondents replied that they would screen patients annually, and 57.1% that they would screen more frequently if requested by a patient. The respondents' answers on cervical cancer screening intervals after hysterectomy are portrayed in Fig. 2. Most respondents would extend the screening interval or cease screening in a woman with a history of hysterectomy for a non-preinvasive lesion. Most respondents in the current study preferred conventional cytologic screening method to liquid-based cystology (LBC) regardless of their professional position and practice setting, and the Fig. 3 summarizes the result. Fig. 4 shows that most (65.8%) respondents preferred conventional cervical cytologic testing to LBC, and the major determining factor was high cost. The reasons for selecting screening method were different in these two groups (p<0.001, Student t test). The attitudes of respondents toward the ACS cervical cancer screening guidelines are listed in Table 3. According to the table, the majority of respondents (58.7%) agreed 2-yr screening interval using liquidbased cytologic testing. However, if the option became available to combine screening with Pap and HPV DNA testing every 3 yr, 33.9% would adopt this strategy, but 65.7% of respondents would not adopt it despite negative results by both Pap and HPV DNA testing. The respondents' answers on the strategy adopted in those with an abnormal cytology, and on the preferred follow-up method are shown (Fig. 5). Most respondents (80.3%) replied that they use a HPV DNA test and Pap for follow-up after a loop electrosurgical excision procedure (LEEP) for preinvasive cervical lesions.


Cost is a barrier to widespread use of liquid-based cytology for cervical cancer screening in Korea.

Chung HH, Kim JW, Kang SB - J. Korean Med. Sci. (2006)

Reasons (white chart, cost; black chart, accuracy) for selecting screening method among respondents (p<0.001, Student t test). Over 90% of physicians who preferred liquid-based cytology replied that they selected it for screening method due to higher accuracy than conventional cytology.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2721928&req=5

Figure 4: Reasons (white chart, cost; black chart, accuracy) for selecting screening method among respondents (p<0.001, Student t test). Over 90% of physicians who preferred liquid-based cytology replied that they selected it for screening method due to higher accuracy than conventional cytology.
Mentions: Most respondents replied that they would screen patients annually, and 57.1% that they would screen more frequently if requested by a patient. The respondents' answers on cervical cancer screening intervals after hysterectomy are portrayed in Fig. 2. Most respondents would extend the screening interval or cease screening in a woman with a history of hysterectomy for a non-preinvasive lesion. Most respondents in the current study preferred conventional cytologic screening method to liquid-based cystology (LBC) regardless of their professional position and practice setting, and the Fig. 3 summarizes the result. Fig. 4 shows that most (65.8%) respondents preferred conventional cervical cytologic testing to LBC, and the major determining factor was high cost. The reasons for selecting screening method were different in these two groups (p<0.001, Student t test). The attitudes of respondents toward the ACS cervical cancer screening guidelines are listed in Table 3. According to the table, the majority of respondents (58.7%) agreed 2-yr screening interval using liquidbased cytologic testing. However, if the option became available to combine screening with Pap and HPV DNA testing every 3 yr, 33.9% would adopt this strategy, but 65.7% of respondents would not adopt it despite negative results by both Pap and HPV DNA testing. The respondents' answers on the strategy adopted in those with an abnormal cytology, and on the preferred follow-up method are shown (Fig. 5). Most respondents (80.3%) replied that they use a HPV DNA test and Pap for follow-up after a loop electrosurgical excision procedure (LEEP) for preinvasive cervical lesions.

Bottom Line: Over 65% of respondents preferred conventional cytologic screening to liquid-based cytology.Fifty-three percent used the human papillomavirus DNA test as a triage for atypical squamous cells of undetermined significance.Our findings suggest that majority of Korean obstetricians and gynecologists in hospital prefer annual conventional cytologic testing to liquid-based cytology for financial reason.

View Article: PubMed Central - PubMed

Affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, 28 Yongon-Dong, Chongno-Gu, Seoul, Korea.

ABSTRACT
This study aimed to document current cervical cancer screening practices of physicians in Korea. Questionnaires were distributed to 852 Korean obstetricians and gynecologists, who attended the 91st Conference of the Korean Society of Obstetrics and Gynecology held during May, 2005. Questionnaires were returned by 30.6% (260/852) of the recipients and 254 of these were eligible for analysis. Sixty-seven percent started cervical cancer screening women at age 20, and 65% replied that they would continue annual screening in a 35-yr-old woman with three consecutive normal cytologic tests. Over 65% of respondents preferred conventional cytologic screening to liquid-based cytology. The cost was a major determinant for selecting screening method. Fifty-three percent used the human papillomavirus DNA test as a triage for atypical squamous cells of undetermined significance. Our findings suggest that majority of Korean obstetricians and gynecologists in hospital prefer annual conventional cytologic testing to liquid-based cytology for financial reason.

Show MeSH
Related in: MedlinePlus