Saturday, 19 December 2009

Screening Programme Criteria

Wilson & Jugner Screening Programme Criteria (criteria all screening programmes should meet to provide maximum benefits to minimum cost*)

*cost as in medical/social, as opposed to simply monetary cost

Making sense of screening - science leaflet

Added 21 Dec 09 - False/negative results in screening programmes and impacts (analysis)

Added 1 Jan 2010 - The psychiatric effects of mass screening

Rates of cancer, cervical cancer and other serious illnesses

Causes of death, male and female, UK 2010

World Health Organisation - causes of death in women worldwide

Added 20 Dec 09
Cervical cancer incidences by age etc in the UK

Added 21 Dec 09
Cervical cancer link to early sex

Cancer in Australia, an overview, 2006

Types of cancer and information (US)

United States Cancer Statistics

Estimated new cancer cases and deaths by sex, US, 2005-2011, including splits by ethnicity

Re-evaluating the risk of breast cancer - article on the distraction of cancer from other major health risks

Added 27th Dec 09 - pages 849 and 850 most relevant
"The risk of death by age, sex and smoking status in the US - putting risks in context"

Added 1 Jan 2010
Incidences of cervical cancer

Added 1 Jan 2010
The social and demographic characteristics of women dying from cervical cancer in Nottingham (UK)

Added 8 Jan 2010
Social/demographic/medical 'stuff' per State (USA)

Added 9 Jan 2010
Way of calculating what you might die of (for when you don't want to sleep at night....)

Added April 2010
Sexual practices and menstruation - risks for cervical cancer (South Africa)

Added July 2010 - women living with incurable STDs

"Added Decenber 2011 - (there's no internet link and I cannot upload a copy due to copyright, however this should be available in most medical libraries).
Journal of American College of Cardiology, Vol. 58, No. 19, 2011 "a report of significant association between being HPV positive and the presence of atherosclerotic heart disease."

Informed Consent and Ethics

Feminist perspectives on health care law

Reaching targets in the national screening programme - are current practices unethical?

Informed consent is missing from cervical screening

The ethics of information: absolute risk reduction and patient understanding of screening

Randomised controlled trial of the effect of evidence based information on women's willingness to participate in cervical cancer screening

Patients & Informed consent

Are women sufficiently well informed to provide valid consent for the cervical smear test?

Women must be given fuly informed information about cervical screening - BMJ article

General practitioner's perception of risk factors for cervical cancer development: consequences for patient education

Informed consent? How do primary care professionals prepare women for cervical screening: a qualitative study$=relatedarticles&logdbfrom=pubmed

Added 21st Dec 09
US paper - the Competent Patient's Right to refuse treatment

Added 21st Dec 09
Interventions targeted at women to increase uptake of cervical smears

Added 21st Dec 09
Interesting post on the manufacture of consent

Added 6 Jan 2010
Rethinking informed consent - the case for shared medical decision making

Added 6 Jan 2010
New Zealand Article on consent to screening

Added 15th Jan 2010
Little vignette on the subject of consent, by a GP blogger

Added 13 Feb 2010
Pap smear brochures, misogyny and language - a discourse analysis and feminist critique

Added 13 Feb 2010
Consent to screening (NZ)

Added 15 Feb 2010
A Scottish GP's opinion...

Added 25 Feb 2010
Gender and trust in medicine: consent, abuses and remedies

Added 25 Feb 2010
Cervical screening - compliance and moral obligation

Added 19 Mar 2010 -bridging the knowledge gap and communicating uncertainties for informed consent in cervical cytology; we need unbiased information and a culture change

Added 15 Jan 2010 Complex paper about attempts to persuade women into breast and cervical screening

Added 28th June 2011 - Blog post about plans for compulsory cervical exams in Poland

Smear testing - pros, cons and effectiveness

Who should get a pap smear?

Dr Angela Raffle - letter to British Medical Journal

More than you need to know? These days, we are screened for a whole raft of diseases. But just how effective are they?

Trade-offs in cervical cancer prevention, balancing benefits and risks

Does cancer screening save lives?

Are mammograms and PSA tests overrated?

Should we abandon pap testing?

Outcomes of screening to prevent cancer: analysis of cumulative incidence of cervical
abnormality and modelling of cases and deaths prevented

Jade and the dangers of smear testing

Low-risk women should not be over-screened for cervical cancer

Low risk of cervical cancer during a long period after negative screening in the Netherlands

At what age do cancer tests offer more risks than benefits?

Screening for older citizens,0,7041458.story

Colposcopy rates and results

Dr Angela Raffles book on screening practice

Added 21 Dec 09
UK cervical cancer screening programme and statistics - 2010-11

Added 21 Dec 09 Finnish Screening evaluation study

Added 21 Dec 09
Explanation of CIN1, CIN2 etc

Added 21 Dec 09
Effect of screening on incidence of and mortality from cancer of cervix in England: evaluation based on routinely collected statistics

Added 21 Dec 09
Cervical cancer - a guide for nurses

Added 1 Jan 2010 - Debates about cervical screening - a historical overview

Added 1 Jan 2010 - Is cervical screening working - a cytopathologists view from the United Kingdom

Added 6 Jan 2010 - Cancer screening - what could hurt?

Added 16 Jan 2010 - Detection rates for abnormal cervical smears - what are we screening for?

Added 22 Jan 2010- Trade offs in cervical cancer prevention

Added 13 Feb 2010 Debates about cervical screening - an historical overview

Added 25 Feb 2010 - Making the pap smear into the right tool - cervical cancer in the USA circa 1940 - 1995

Added 25 Feb 2010 - Cervical screening in lesbian and bisexual women

Added 25 Feb 2010 - collection of articles on colposcopy

Added 28 April 2010 Risks to pregnancies post-cervical screening and treatment

Added May 01 2010 - cervical screening transexuals (MtF/FtM)

Added April 2011 - comprehensive report on the set up and management of the Welsh cervical screening programme

Added April 2011 - report on screening in Peru

Added November 2011 - indepth study on lesbian, gay and bisexual women and cervical screening, in the northwest of the UK (Salford)

Women's Perceptions & Experiences of Screening

Women's experiences at cervical screening

Factors affecting attendance for a cervical smear test: a prospective study

Personal influencing factors associated with pap smear testing and cervical cancer$=relatedarticles&logdbfrom=pubmed

Risk factors for cervical cancer development: what do women think?$=relatedarticles&logdbfrom=pubmed

Women's knowledge and experience of cervical screening: a failure of health education and medical organisation

Screening for cervical cancer: a review of women's attitudes, knowledge and behaviour

Uptake of cervical cancer screening in the Netherlands is mainly influenced by women's beliefs about the screening and by the inviting organisation

Individualing a general medical discourse: women making sense of cervical cancer screening in the UK

The impact of knowledge, perceived barriers and perceptions of risk on attendance for a routinue cervical smear

Frequency of after-effects reported by women following a cervical smear test

A survey of female nursing students' knowledge, health beliefs, perception of risk and risk behaviours regarding HPV and cervical cancer$=relatedarticles&logdbfrom=pubmed

Factors influencing cancer screening practices of underserved women$=relatedreviews&logdbfrom=pubmed

Perceived cervical cancer risk among women undergoing colposcopy

Psychological effects of a low-grade abnormal cervical smear test result: anxiety and associated factors

Women's understanding of abnormal cervical smear results: a qualitative interview study

What do women think about abnormal smear test results? A qualitative interview study

Added 21 Dec 09
Women's experiences of cervical screening

Added 21 Dec 09
Women's understanding of a "normal" smear test result - experimental questionnaire based study

Added 21 Dec 09
Improving the quality and coverage of cervical screening - women's views

Added 1 Jan 2010
Australian Women's needs and preferences for information about HPV in cervical screening

Added 1 Jan 2010
Women's experiences of gynaecological care

Added 1 Jan 2010
Article re: sexual abuse victims refusing smear tests (Australia)

Added 1 Jan 2010
Irish screening authority report on cervical screening and improving uptake

Added 1 Jan 2010
Cognition and affect after cervical screening - the role of previous test outcomes and personal obligation in future uptake expectations

Added 6 Jan 2010 Article on attempts to make positive smear results less worrying for women

Added Jan 16 2010 Women's experiences of abnormal cervical cytology - illness representations, care processes and outcomes

Added 13 Feb 2010 - The potential for feminist political practice to empower the underrepresented consumer: the case of cervical cancer screening services

Added 25 Feb 2010 - Feminist healthcare with out of the mainstream adolescent females

Added 25 Feb 2010 - During cervical screening, women desired good communication and sensitivity from their doctor

Added 25 Feb 2010 - women with learning disabilities and access to cervical screening - retrospective cohort study using case control methods

Added 25 Feb 2010 - breast and cervical screening for women with mental illness: patient and provider perspectives

Added 25 Feb 2010 - cervical screening: the knowledge and opinions of black and minority ethnic women and of health advocates in East London

Added 25 Feb 2010 - Correlates of cervical cancer screening between underserved african american and hispanic women

Added 25 Feb 2010 - breast and cervical cancer in indigenous women - barriers to early detection$=relatedarticles&logdbfrom=pubmed

Added 25 Feb 2010 - marrying research, clinical practice and cervical screening in Australian aboriginal women

Added 26 Feb 2010 - Influences on the uptake of reproductive health services in Uganda and implications for breast and cervical screening

Added 12 Mar 2010 - Women with learning disabilities and cervical screening

Mar 2010 - Cervical cancer/Brazilian women in the Favelas

Feb 2011 - Issues with New Zealand screening programme (study done without the participants' consent)

December 2011 - The role of primary care professionals in women’s experiences of cervical cancer screening: a qualitative study

and as the above link is only accessible to subscribers, a short BBC report on it:

Incentives for health professionals to promote screening

UK Parliament discussion on GP renumeration and effects on patient consent

Health: GPs 'bully women into smears for cash' (UK)

Decisions about Pap tests - what influences women and providers? (Australia)

Added 21 Dec 09
Can financial incentive affect GP practice?

Added 21 dec 09
The appropriate use of financial incentives to encourage preventative care in general practice

Added 21 Dec 09
Promoting screening for cervical cancer: realising the potential for recruitment for general practitioners

Frequency and Age of screening - pros and cons

Rates of cervical cancer screening in the US

New cervical cancer guidelines (end of yearly testing)

Added 21 Dec 09
Quinquennial (5-yearly) smears - every woman's right and every general practitioners responsibility (paper dated 1984) UK

Added 21 Dec 09
Article on the decision not to screen at age 20 in the UK

Added 23 Dec 09
Article discussing changing first age of screening from 20 to 25 (Australia)

Added 1 Jan 2010
Hansard - UK Parliament discussion on possibly changing the smear test age from 25 to 20

Added 23 Jan 2010
Decision not to reduce the age of screening in the UK from 25 to 20

Added 29 Jan 2010
Findings and outcomes of teenage women referred for colposcopy in Christchurch (New Zealand)

Added 14 Feb 2010
Emotion vs evidence re: dropping screening age

Added 25 Feb 2010
Should we discontinue pap smear testing in women >65 years of age?

Added 12 Mar 2010 -Cervical screening - when to start? (New Zealand)

Added Mar 2010
Smear tests in virgins

Added Apr 2010
Study providing scientific background to UK screening being moved to over-25s

Added April 13 2010 - Article on efficiency of varied frequency and age of screening (UK)

Added April 18 2010 - article on decision to keep screening age at 25 (UK)

Added June 2010
UK research paper on effectiveness in screening the under-25s

Added Jan 2011 - Risk of cervical abnormality in women over 50 with previous negative history

Official Recommendations and Information Leaflets

NHS Evidence - screening leaflet

Added 21 Dec 09
Cervical Screening - The Facts (screening leaflet, UK)

Guidelines push back age for cervical cancer test

Australian cancer screening recommendations

Cervical Screening Information

Added 21 Dec 09
Inviting women for screening - what messages do leaflets convey?

Added 6 Jan 2010 - BUPA (UK private healthcare provider) information leaflet

Added 25 Feb 2010 - smear test leaflet - LGBT UK

Added 25 Feb 2010 - What's pants but could save your life? Increasing cervical cancer utilisation in the UK

Added 12 Mar 2010 - Cervical Cancer Charity (UK)

Added 17 Mar 2010 - screening and pregnancy (UK)

Added 17 mar 2010 screening and pregnancy (UK)

Added 17 mar 2010 screening and pregnancy (New Zealand)

Added 17 mar 2010 screening and pregnancy (USA)

Added 17 mar 2010 screening and pregnancy (USA)

Sept 2010 Australian cervical screening website

Oct 2010 - Clinical guidance (UK) on when to cease recalling women for smears.

Feb2011 Official information on how screening guidelines are decided (UK)

Discussion Forums and Personal Anecdotes

....from the horse's mouth, as it were...most women's websites will have a thread going on screening and personal experiences, these are just a small sample.

Very good forum discussing patient privacy and consent. Many of the articles posted on this site originally were posted on that forum by the members (many thanks, ladies and gentleman!)

General discussion, smear tests and contraceptive use

A great grandmother of a discussion - been going since 2005!  Still going strong and some of the regulars seem to be organising a separate website on female gynaecology which may be of interest.  Thankfully they seem to have shaken off the infestation of male trolls with a gynaecology fetish.....

UK cervical screening discussion board

Blog giving a summary of some of most commonly quoted links and articles on this subject

Newspaper Articles

Article by UK woman who decided to cease having smears based on informed risk/benefit analysis.

Article by UK women urging young women to have smears.

Article by UK mental health patient who decided to cease having smears based on bad experiences with testing

Cancer screening smackdown continues - pap smears and colonoscopies take a hit

Added 21 Jan 2010
Article on fallout from breast cancer screening false positives

6 June 2011
Balanced pros and cons article on screening by age

9 June 2011
Set of articles around cervical cancer, vaccination etc by Debora Miranda

and Debora's related website, on the subject of her journalism MA

Screening as pre-requisite for the Pill

Apparently the USA generally ties prescribing of the contraceptive pill to smear tests (i.e. no pap smear, no pill). I'm glad I live in the UK....

General overview of hormonal contraception

Why do I need a pap smear to get birth control?

Added 21 Dec 09
Readers' responses to the above article "Why do i need a pap smear to get birth control?"

Article on the need for annual gynaecological exams for contraceptive pills - no weblink
Clinical Breast and pelvic examination requirements for hormonal contraception: current practice vs evidence
Felicia H. Stewart, Cynthia C. Harper, Charlotte E. Ellertson, David A. Grimes, George F. Sawaya, James Trussell, JAMA. 2001;285:2232-2239

Should the pill be available without prescription? Yes.

Are breast/pelvic exams necessary for women starting oral contraception

Possible role of the Pill in increased cervical cancer, and rates of risk

Added 1 Feb 2010
'Should oral contraceptives be available without prescription' by James Trussell, Felicia Stewart, Malcolm Potts, Felicia Guest and Charlotte Ellerton, American Journal of Public Health, August 1993, Vol 83, No 8, pages 1095 - 1099.

Added 17 mar 2010 pill without smears (some of the cited links in this article are broken)

Added 17 mar 2010 - provision of contraceptives without a mandatory pelvic examination - the First Stop Demonstration Project

April 2010
Blog essay on cervical screening vs pill prescription

Feb 2011
Some articles on screening v the Pill

Screening After Hysterectomy

NHS screening information including post-hysterectomy information

Too many needless pap smears?

Pelvic Examinations in Asymptomatic Women

.....i.e opportunistic pelvic examinations in women with no symptoms of gynaecological issues, rather than smear tests.

Pelvic examination of asymptomatic women - attitudes and clinical practice

Breast examination and pelvic examination of asymptomatic women: evidence and clinical practice

April 2010
Article on annual physicals

January 2011 - Improving routine gynaecological examinations in women - stirrups versus no stirrups

Amendments to Screening Practices & Policies

Cervical screening - time to change the policy

Where recent changes to screening guidelines go wrong

Added 21 Dec 09
Cervical cytology screening and government policy (UK)

Added 4 Jan 10
Politics and amendments to cancer screening

Added 13 Feb 2010
Discussion on changes to mammogram and cervical cancer screening (US)

Added 25 Feb 2010
Possible changes to smear test screening in the USA

Added 12 Mar 2010 - How can the uptake of cervical screening be improved?$=relatedreviews&logdbfrom=pubmed

Added 7 May 2010


Developments in Screening Techniques

Added Dec 21 09
The legacy of the Pap smear, and what came next

Added 13 Jan 2010
On the use of biomarkers

Added 12 Mar 2010
Possible home testing kit

Added 15 Mar 2010 - Home testing kits

HPV/HPV Vaccine

Risks and benefits of HPV vaccination

Cervical cancer and HPV

The epidemiology of human papillomavirus infection and cervical cancer$=relatedreviews&logdbfrom=pubmed

Condoms help protect against cervical cancer

Genital HPV - CDC sheet

Cervical cancer prevention: the saga goes on, but so much has changed!

HPV test

FDA panel backs giving HPV vaccine Gardasil to young males

FAQS for Men

Added 10 Mar 2010 Trade offs in cervical cancer prevention

Added 29 November 2011 - Interesting Graphic regarding safety of HPV vaccine

"Added November 22 2011 - (there's no internet link and I cannot upload a copy due to copyright, however this should be available in most medical libraries).
Journal of American College of Cardiology, Vol. 58, No. 19, 2011 "a report of significant association between being HPV positive and the presence of atherosclerotic heart disease."

Mammogram Screening

UK Breast Cancer Screening Leaflet

Weighing the benefits of a mammogram,0,1732820.story

Why I am a screening sceptic - Dr Michael Baum

Breast screening: the facts - or maybe not

Danish screening information leaflet

The effectiveness of breast exams

New mammograms guidelines raise questions

Women decline free mammograms for cancer,25197,26047148-2702,00.html

Making personal decisions about X-ray screening tests

Can radiology dodge the blowback in breast cancer screening?

Added 3 Jan 2010
Blog article on changes to screening practices

Article on informed consent - Hazel Thornton

Added 6 Mar 2010
Article on amendment to screening

Added Mar 2010
Study vindicates breast cancer screening

Added May 21 2010