title: Health technology assessment on cervical cancer screening, 2000-2014.
abstract: OBJECTIVE
  The aim of this study was to conduct a review of health technology assessments (HTAs) in cervical cancer screening to highlight the most common metrics HTA agencies use to evaluate and recommend cervical cancer screening technologies.
  
  
  METHODS
  The Center for Reviews and Dissemination (CRD), MedLine, and national HTA agency databases were searched using keywords ("cervical cancer screening" OR "cervical cancer" OR "cervical screening") and "HTA" from January 2000 to October 2014. Non-English language reports without English summaries, non-HTA reports, HTAs unrelated to a screening intervention and HTAs without sufficient summaries available online were excluded. We used various National Institute for Health and Care Excellence (NICE) methods to extract key assessment criteria and to determine whether a change in screening practice was recommended.
  
  
  RESULTS
  One hundred and ten unique HTA reports were identified; forty-four HTAs from seventeen countries met inclusion criteria. All reports evaluated technologies for use among women. Ten cervical screening technologies were identified either as an intervention or a comparator. The most common outcome metric evaluated was diagnostic accuracy, followed by economic effectiveness. Additional outcome metrics such as the use of adjunct testing, screening intervals, and age-specific testing were commonly evaluated. Nearly one-third (fifteen of forty-four) of HTAs recommended a change in practice.
  
  
  CONCLUSIONS
  This review highlights popular metrics used in HTAs for cervical cancer screening. Clinical and economic effectiveness metrics have been consistently assessed in HTAs, while the use of adjunct testing, screening intervals, and age-specific screening became increasingly prevalent from after 2007. Moreover, we observed an increase in optimized recommendations after 2007.
authors.affiliation: BD Health Economics and Outcomes Research.
authors.forename: Betsy J
authors.initials: BJ
authors.lastname: Lahue
authors.affiliation: BD Health Economics and Outcomes Research.
authors.forename: Eva
authors.initials: E
authors.lastname: Baginska
authors.affiliation: BD Health Economics and Outcomes Research.
authors.forename: Sophia S
authors.initials: SS
authors.lastname: Li
authors.affiliation: BD Health Economics and Outcomes Researchmonika_parisi@bd.com.
authors.forename: Monika
authors.initials: M
authors.lastname: Parisi
mesh_terms: D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D013673:Technology Assessment, Biomedical / Q000458:organization & administration*; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*
keywords: Diagnostic services; Mass screening; Technology assessment; Uterine cervical neoplasms; Vaginal smears