title: Paying for prevention standardizing the measurement of the value of health care interventions.
abstract: It is not clear if spending more on tests that enhance the accuracy of Pap smears would lead to a greater reduction in cancer incidence than if the money were spent to include a greater proportion of women in primary screening. The cost effectiveness of tests beyond the Pap smear has not been clearly demonstrated. There is the question of whether cervical cancer incidence can be decreased more by improving the tests for patients who are already screened or by improving access to the unscreened population. Cervical cancer screening represents only one of many public health issues competing for resources. Given that there are choices to be made, the optimal yardstick against which all resource-competing programs are measured should be marginal benefit versus marginal cost.
authors.affiliation: Department of Gynecologic Oncology, Kaiser Permanente, 4900 Sunset Boulevard, Building M, Los Angeles, CA 90027, USA. Steven.A.Vasilev@kp.org
authors.forename: Steven A
authors.initials: SA
authors.lastname: Vasilev
mesh_terms: D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000191:economics*; D065006:Papanicolaou Test; D027383:Papillomaviridae / Q000145:classification; D040841:Resource Allocation; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000473:pathology / Q000517:prevention & control* / Q000821:virology; D014626:Vaginal Smears / Q000191:economics* / Q000592:standards*; D002578:Uterine Cervical Dysplasia / Q000191:economics / Q000473:pathology / Q000517:prevention & control* / Q000821:virology