Comparative Effectiveness of the Cervical Cancer Screening Process: Past, Present

尽管巴氏涂片筛查降低了美国宫颈癌的发病率， 癌症仍然与大量的发病率和死亡率相关，导致种族和 种族差异，并造成高昂的经济成本。癌症流行病学与医学进展 技术提供了一个显着的机会，以提高效率和效率的 宫颈癌筛查过程。然而，在临床决策方面仍然存在关键挑战 以及采用最佳实践，涉及患者行为、提供者激励、健康 系统，以及新兴技术的实际临床有效性。我们建议聘请一名 决策分析方法，通过利用临床数据调整现有建模框架 供应商网络和最先进的宫颈癌信息登记处在新墨西哥州;评估 并权衡整个连续体中替代宫颈干预措施的权衡（益处和危害） 护理;探索其结果的不确定性;纳入患者行为的信息， 真实世界的实践;并及时告知临床和政策问题。通过实现我们的具体目标，我们 预期会对（1）子宫颈癌普查的成效和效率产生影响 通过调查最佳实践的可接受性、交付和采用的影响， 癌症结果，包括降低发病率，通过早期检测提高生活质量， 提高生存率，减少不平等;（3）公平分配和合理使用新的 （4）与子宫颈癌有关的医疗机构的财政及经济状况 癌症控制

Although Pap smear screening has reduced cervical cancer incidence in the United States, cervical cancer continues to be associated with substantial morbidity and mortality, contributes to racial and ethnic disparities, and Imposes high economic costs. Advances in cancer epidemiology and medical technology provide a remarkable opportunity to improve upon the effectiveness and efficiency of the cervical cancer screening process. However, critical challenges remain with respect to clinical decision making and adoption of best practices, pertaining to patient behavior, provider incentives, health systems, and the real-world clinical effectiveness of emerging technologies. We propose to employ a decision-analytic approach, adapting an existing modeling framework by leveraging data from clinical provider networks and a state-of-the-art registry of cervical cancer Information in New Mexico; evaluate and weigh the tradeoffs (benefits and harms) of alternative cervical interventions across the continuum of care; explore the uncertainty around their outcomes; incorporate information on patient behavior and real-world practice; and inform timely clinical and policy questions. By achieving our specific aims, we expect to have an impact on (1) the effectiveness and efficiency of the cervical cancer screening process by investigating the effects of acceptability, delivery, and adoption of best practices; (2) cervical cancer outcomes, including reduced incidence, enhanced quality of life through earlier detection, improved survival, and reduced disparities; (3) the equitable distribution and rationale use of new technology; and (4) the financial and economic profile of health care organizations related to cervical cancer control.