Timeliness of cervical cancer diagnosis and initiation of treatment in the National Breast and Cervical Cancer Early Detection Program

J Womens Health (Larchmt). 2012 Jul;21(7):776-82. doi: 10.1089/jwh.2011.3224. Epub 2012 Apr 16.

Abstract

Objectives: To examine time intervals from cervical cancer screening to diagnosis and treatment initiation among low-income and uninsured women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) during two consecutive time periods.

Methods: We analyzed NBCCEDP data for women with abnormal Pap tests (n=100,167), from which 1,417 invasive cervical cancers were diagnosed. We examined two time intervals for this study: diagnostic interval (time from abnormal Pap test to the date of definitive diagnosis) and treatment initiation interval (time from definitive diagnosis to treatment initiation) for two time periods: 1996-2002 and 2003-2009. We compared median time intervals for diagnostic and treatment initiation using the Kruskal-Wallis test. Adjusted proportions (predicted marginals) were calculated using logistic regression to examine diagnosis and treatment within program benchmarks (≤60 days).

Results: Median diagnostic intervals decreased overall by 6 days (54 vs. 48 days, p<0.001). This decrease in the median diagnostic interval was noted for all variables examined. The median treatment initiation intervals remained stable over the two time periods.

Conclusions: Women screened by the NBCCEDP receive diagnostic follow-up and initiate treatment within preestablished program guidelines.

MeSH terms

  • Adolescent
  • Aged
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / epidemiology
  • Breast Neoplasms / therapy*
  • Early Detection of Cancer / standards
  • Early Detection of Cancer / statistics & numerical data*
  • Early Detection of Cancer / trends
  • Female
  • Humans
  • Logistic Models
  • Mass Screening / standards
  • Medically Uninsured / psychology
  • Medically Uninsured / statistics & numerical data
  • Middle Aged
  • Physical Examination
  • Population Surveillance
  • Poverty / psychology
  • Poverty / statistics & numerical data
  • Program Evaluation
  • Residence Characteristics / statistics & numerical data
  • Socioeconomic Factors
  • Statistics, Nonparametric
  • Time Factors
  • United States / epidemiology
  • Uterine Cervical Neoplasms / diagnosis*
  • Uterine Cervical Neoplasms / epidemiology
  • Uterine Cervical Neoplasms / therapy
  • Vaginal Smears / psychology
  • Vaginal Smears / statistics & numerical data
  • Young Adult