Cost effectiveness of rescreening cervicovaginal smears.
Although cytology laboratories are mandated to rescreen at least 10% of cervicovaginal smears, there is no uniform national rescreening practice. Follow-up data for 16,188 rescreened cervicovaginal smears were studied and decision analysis was performed to determine an optimal rescreening strategy. High-grade dysplasia was detected in 0.40% of women with a history of cervical disease and in 0.04% without a history of cervical disease. Compared with 0% rescreening of smears, with 15% rescreening the cost to gain a year of discounted life expectancy was $386,890 for women without a history of cervical disease, and $2,980 for women with a history of cervical disease. We conclude that rescreening only smears from women with a history of cervical disease could save US laboratories more than $11.2 million annually without seriously compromising care.
Raab
S S
SS
Department of Pathology and Laboratory Medicine, Allegheny University of Health Sciences, Pittsburgh, PA 15212-4772, USA.
Bishop
N S
NS
Zaleski
M S
MS
D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D017048:Health Care Costs; D006801:Humans; D008017:Life Expectancy; D008499:Medical Records; D008962:Models, Theoretical; D012016:Reference Values; D012680:Sensitivity and Specificity; D002577:Uterine Cervical Diseases / Q000473:pathology; D014626:Vaginal Smears / Q000191:economics*