Cost-effectiveness of rescreening conventionally prepared cervical smears by PAPNET testing.
OBJECTIVE
This study explored the cost-effectiveness of the use of PAPNET testing-supplemental, neural network-based testing used to increase the accuracy of cervical smear screening practice.


METHODS
Using a model adapted from one developed under contract from the United States Congress Office of Technology Assessment to evaluate cost-effectiveness of cervical cancer screening in elderly women, the study evaluated U.S. women aged 20-64. The study reviewed various screening intervals and examined the course of follow-up (i.e., repeat abnormal smear vs. immediate colposcopy) to offer a range into which most routine medical practice will fall.


RESULTS
Assuming a false negative rate of 25% for low grade squamous intraepithelial lesion (SIL) and 15% for high grade SIL and applying increased sensitivity of 30% from PAPNET, we can expect a cost of $48,474 per life-year saved among biennially screened women. For women screened triennially, as recommended by most groups, the cost per life-year saved is $25,185.


CONCLUSIONS
The PAPNET rescreening program is an economical approach to decreasing mortality and morbidity from cervical cancer and compares favorably to other commonly used interventions and diagnostic procedures.
Schechter
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CB
Department of Community Medicine, Mt. Sinai School of Medicine, New York, New York, USA.
D000328:Adult; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D016571:Neural Networks, Computer; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears / Q000191:economics*; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control*