Marshall et al (2009) stated that "[t]he risk of completing a screening program is increased by multiple factors, including, but not limited to, embarrassment, anatomical occlusion, lack of knowledge and understanding, pain, cost, fear of the Pap smear, and dissatisfaction with the colposcopy procedure. A screening intervention designed to balance these varied and often competing interests is increasingly likely to be complex and diverse in approach. As members of Screen-ICP, we have reviewed the literature and obtained the expert opinion of multiple representatives from innovators, policy makers, public health organizations in Canada and the United States, and community members throughout Canada, to inform the design of a successful screening program in Canada. We must continue to make patient-centered evidence available to policy makers, as well as to the public. But, first, healthcare professionals must continue to be educated in the care of their patients and will rely on such information in their daily practice".
Heron et al (2009) stated that "[i]ntended differences in site-specific factors during screening and diagnostic procedures (i.e., differences between clinicians, facilities, and settings) can lead to differences in the results obtained by screening programs. In the 2006 American Society of Clinical Oncology guideline, those factors were considered a key obstacle to the successful implementation of cervical cancer screening programs, largely because of the lack of systematically collected, risk-specific data on implementation factors. Very little attention has been paid in the literature to the lack of consistency in cervical cancer screening in comparison with other cancers, so it is not known whether the factors causing this lack of consistency in screening uptake in cervical cancer are similar to those factors that prevent the consistent implementation of screening programs for other cancers."
In the afore-mentioned article, Chin et al (2009) stated that "[i]t is clearly important to continue to develop new screening strategies that might balance the benefits and harms of Pap screening while improving the identification of high-grade lesion. The recognition of good and bad biomarkers that predict cervical transformation is crucial for our understanding of the natural history of precancer and for improving clinical decision-making. Gene expression profiling has revealed signatures that are associated with atypical cells and cervical neoplastic progression. d2c66b5586