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Cervical cancer screening overtesting


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Cervical cancer screening tests are  significantly overused in women at average risk for cervical cancer in the United States.


Studies suggest that among commercially insured women with average risk who undergo cervical cancer screening, cervical cancer screening tests are frequently overused.


Women with two or more comorbidities are  less likely to undergo repeat screening than those with no comorbidities.


Women screened with co-testing compared with women who underwent cytologic testing alone are  less likely to undergo repeat screening.


Women who were pregnant, who had gynecologic symptoms and those with mental health or substance abuse issues ate less likely to undergo repeat screening.


Overtesting is  particularly common in younger women and in women screened with cytologic testing alone.


Overuse of cervical cancer screening has significant consequences: low-grade abnormal findings are likely to result in further diagnostic testing including colposcopy and biopsy and even ablative or excisional procedures.


Such procedures are often associated with psychological stress and physical symptoms.


Treatment of preinvasive cervical lesions is associated with adverse pregnancy outcomes, including preterm birth.


There is minimal financial disincentive for clinicians to perform more frequent testing.


Identification of low-grade abnormalities during the unnecessary cervical cancer screening can lead to further diagnostic testing and adverse psychological and physical consequences for patients.


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