George Sawaya, MD
Associate Professor, Departments of Obstetrics, Gynecology & Reproductive Sciences and Epidemiology & Biostatistics
Director, Cervical Dysplasia Clinic, San Francisco General Hospital
Email: sawayag@obgyn.ucsf.edu
Biosketch:
Dr. Sawaya’s main research program involves all major aspects of cervical cancer screening including the optimal age to begin screening, age to end screening, screening periodicity and screening technologies. He has a secondary topical interest in investigating novel agents for the treatment of menopausal symptoms. His methodological interest is in systematic literature reviews and meta-analyses of various topics in women’s health.
Dr. Sawaya’s initial studies in cervical cancer screening were completed with support from a four-year, NCI-sponsored Mentored Clinical Scientist Development Award focused on determining the risks and benefits of cervical cancer screening, specifically in older women. He determined the risk of false positive testing and risk factors for the development of cytological abnormalities in over 2500 postmenopausal women. The resulting publication is widely cited by screening guidelines and was selected by American College of Physicians-American Society of Internal Medicine as one of the 10 most important papers in women’s health published in 2000. He collaborated with investigators at Kaiser Permanente’s Division of Research to determine reasons why women in a pre-paid health plan with easy access to cervical cancer screening develop cervical cancer. Using case-control methodology, the group also estimated risk of cervical cancer associated with extending screening intervals. Under contract with CDC, he completed studies analyzing cervical cancer screening outcomes in over 1 million uninsured women in the United States to determine optimal screening strategies to inform program guidelines; the resulting publication was the lead article in the New England Journal of Medicine and led to cost-effectiveness and cost-utility analyses that had a direct impact CDC program policies and influenced national guidelines. He expanded his studies to address the optimal age to begin screening by describing the potential effect of screening women under age 20 years on cancer incidence in the US. To understand clinicians’ perspectives on screening, he performed a vignette-based survey of US obstetrician/gynecologists. To understand the perspectives of individual women on screening cessation, periodicity and human papillomavirus (HPV) testing, he collaborated with a study group from the Medical Effectiveness Research Center for Diverse Populations at UCSF; over 800 women from a variety of racial/ethnic backgrounds were interviewed. This study also focused on risk perception and risk communication in cancer screening. He recently completed a study involving over 2000 Zimbabwean women to determine the independent effect of latex diaphragm and lubricating gel provision on HPV infection, cytological abnormalities and cervical neoplasia. One study aim is to determine the natural history of HPV infection and the potential role of HPV in HIV seroconversion. He is co-investigator on a large, bi-national project to determine optimal surveillance strategies among women treated for precancerous cervical lesions. The study involves primary outcomes data from British Columbia and state-of-the art cost-effectiveness and cost-utility analyses. To complement his studies in prevention, he has been the site PI on a multi-centered, randomized, placebo-controlled trial of a Chinese herbal compound for the relief of menopausal symptoms. Recruitment for a second larger trial of a similar herbal compound will begin this fall. Other studies focused on relief of vaginal dryness are planned for 2009.
He has demonstrated his commitment to dissemination and implementation of research findings by serving as an invited expert to CDC and the American Cancer Society. He is also a member of the US Preventive Services Task Force, a governmentally supported panel of experts in prevention. He recently led the Task Force’s subcommittee on cervical cancer screening guidelines (anticipated publication, 2009). As an internationally recognized expert in cervical cancer prevention, he is frequently asked to serve on grant review committees and write guest editorials for high-profile journals.
Areas of Interest:
- Meta-analysis and systematic review
- Cervical cancer screening
- Evidence-based medicine
- Women's Health Policy
Publications on PubMed
Updated January 2009