The utility and cost-effectiveness of Pap test rescreening.
Although most laboratories practice 10% manual rescreening of negative Pap tests, the cost-effectiveness of this and other rescreening strategies rarely has been evaluated. A decision model was created in which rescreening strategies were compared with nonrescreening strategies in terms of the number of false negative and positive diagnoses, cancers, life expectancy, and cost-effectiveness. The 10% rescreening with a repeat Pap test strategy yielded almost no gain in life expectancy in comparison to an equivalent strategy with no rescreening. A 100% rescreening strategy generally was more cost-effective than a no-rescreening strategy at costs of rescreening varying from $2 to $10 per patient. We conclude that if the rescreening cost is low, 100% rescreening strategies are more cost-effective than nonrescreening strategies.
Raab
S S
SS
Department of Pathology, Allegheny University of Health Sciences, Allegheny General Hospital, Pittsburgh, PA, USA.
D000328:Adult; D003362:Cost-Benefit Analysis; D020000:Decision Support Systems, Clinical; D003955:Diagnostic Tests, Routine / Q000191:economics*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008017:Life Expectancy; D017063:Outcome Assessment, Health Care; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000191:economics* / Q000592:standards