title: Timeliness of cervical cancer diagnosis and initiation of treatment in the National Breast and Cervical Cancer Early Detection Program.
abstract: OBJECTIVE
  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.
authors.affiliation: Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, USA. vdb9@cdc.gov
authors.forename: Vicki B
authors.initials: VB
authors.lastname: Benard
authors.forename: William
authors.initials: W
authors.lastname: Howe
authors.forename: Janet
authors.initials: J
authors.lastname: Royalty
authors.forename: William
authors.initials: W
authors.lastname: Helsel
authors.forename: William
authors.initials: W
authors.lastname: Kammerer
authors.forename: Lisa C
authors.initials: LC
authors.lastname: Richardson
mesh_terms: D000293:Adolescent; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy*; D055088:Early Detection of Cancer / Q000592:standards / Q000706:statistics & numerical data* / Q000639:trends; D005260:Female; D006801:Humans; D016015:Logistic Models; D008403:Mass Screening / Q000592:standards; D017057:Medically Uninsured / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D010808:Physical Examination; D011159:Population Surveillance; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D015397:Program Evaluation; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D018709:Statistics, Nonparametric; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D014626:Vaginal Smears / Q000523:psychology / Q000706:statistics & numerical data; D055815:Young Adult