Cost-effectiveness of 3 methods to enhance the sensitivity of Papanicolaou testing.
Context ThinPrep, AutoPap, and Papnet are 3 new technologies that increase the sensitivity and cost of cervical cancer screening.
Objective To estimate the cost-effectiveness of these technological enhancements to Papanicolaou (Pap) tests.
Design We estimated the increase in sensitivity from using these technologies by combining results of 8 studies meeting defined criteria.
We used published literature and additional sources for cost estimates.
To estimate overall cost-effectiveness, we applied a 9-state time-varying transition state model to these data and information about specific populations.
Setting A hypothetical program serving a cohort of 20-to 65-year-old women who begin screening at the same age and are representative of the US population.
Results The new technologies increased life expectancy by 5 hours to 1.6 days, varying with the technology and the frequency of screening.
All 3 technologies also increased the cost per woman screened by $30 to $257 (1996 US dollars).
AutoPap dominated ThinPrep in the base case.
At each screening interval, AutoPap increased survival at the lowest cost.
The cost per year of life saved rose from $7777 with quadrennial screening to $ 166 000 with annual screening.
Papnet produced more life-years at a higher cost per year of life saved.
However, when used with triennial screening, each of them produced more life-years at lower cost than conventional Pap testing every 2 years. (...)
Mots-clés Pascal : Tumeur maligne, Col utérus, Frottis cervical, Analyse coût efficacité, Economie santé, Etude comparative, Dépistage, Technique, Homme, Appareil génital femelle pathologie, Col utérus pathologie
Mots-clés Pascal anglais : Malignant tumor, Uterine cervix, Cervical smear, Cost efficiency analysis, Health economy, Comparative study, Medical screening, Technique, Human, Female genital diseases, Uterine cervix diseases
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0114196
Code Inist : 002B20C02. Création : 16/11/1999.