title: Cervical cancer rates after the transition from annual Pap to 3-year HPV and Pap.
abstract: OBJECTIVE
  Kaiser Permanente Northern California (KPNC) introduced 3-year Pap and human papillomavirus DNA cotesting for cervical cancer screening in women 30 years or older in 2003 to 2004. Patient and provider willingness to extend screening intervals and the impact on annual cervical cancer incidence after interval extension are evaluated.
  
  
  METHODS
  Age-adjusted cervical cancer rates and screening intervals were calculated from KPNC Regional Laboratory databases and Northern California Cancer Registry from 2000 to 2009.
  
  
  RESULTS
  The median screening interval between negative cotests was 36 months compared to the 16 months after a negative Pap test alone before the implementation of cotesting. The age-adjusted invasive cancer rate was 6.5 per 100,000 women in 2000 and 6.3 in 2009; there was no difference in the rates of cervical cancer in women 30 years or older from 2000 to 2009 (p(trend) = .7).
  
  
  CONCLUSIONS
  Patients and providers were compliant with the extension of screening intervals with cotesting. Cervical cancer rates remained constant during the 10-year study period despite extending screening intervals after a negative cotest.
authors.affiliation: 1Division of Gynecologic Oncology, Columbia University College of Physicians and Surgeons, New York, NY; 2Regional Laboratory, Kaiser Permanente Northern California, Berkeley, CA; 3Department of Women's Health and Division of Gynecologic Oncology, The Permanente Medical Group, Oakland, CA; 4University of California Santa Barbara (Retired), Santa Barbara, CA; and 5Albert Einstein College of Medicine, Bronx, NY.
authors.forename: Helen
authors.initials: H
authors.lastname: Dinkelspiel
authors.forename: Barbara
authors.initials: B
authors.lastname: Fetterman
authors.forename: Nancy
authors.initials: N
authors.lastname: Poitras
authors.forename: Walter
authors.initials: W
authors.lastname: Kinney
authors.forename: J Thomas
authors.initials: JT
authors.lastname: Cox
authors.forename: Thomas
authors.initials: T
authors.lastname: Lorey
authors.forename: Philip E
authors.initials: PE
authors.lastname: Castle
mesh_terms: D000328:Adult; D002140:California / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000302:isolation & purification*; D030361:Papillomavirus Infections / Q000150:complications / Q000175:diagnosis*; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control