Document Detail


Lifetime effects, costs, and cost effectiveness of testing for human papillomavirus to manage low grade cytological abnormalities: results of the NHS pilot studies.
MedLine Citation:
PMID:  16399769     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: To predict the incremental lifetime effects, costs, and cost effectiveness of using human papillomavirus testing to triage women with borderline or mildly dyskaryotic cervical smear results for immediate colposcopy.
DESIGN: Modelling study.
SETTING: Three centres participating in NHS pilot studies, United Kingdom. Population Women aged 25-64 with borderline or mildly dyskaryotic cervical smear results.
INTERVENTIONS: Screening using conventional cytology, liquid based cytology, and four strategies with different age cut-off points and follow up times that used combined liquid based cytology and human papillomavirus testing (adjunctive human papillomavirus testing).
RESULTS: The model predicts that compared with using conventional cytology without testing for human papillomavirus, testing for the virus in conjunction with liquid based cytology for women with borderline or mildly dyskaryotic cervical smear results (aged 35 or more) would cost 3735 pounds sterling (5528 euros; 6474 dollars) per life year saved. Extending adjunctive human papillomavirus testing in combination with liquid based cytology to include women aged between 25 and 34 costs an additional 4233 pounds sterling per life year saved. Human papillomavirus testing is likely to reduce lifetime repeat smears by 52%-86% but increase lifetime colposcopies by 64%-138%.
CONCLUSIONS: Testing for human papillomavirus to manage all women with borderline or mildly dyskaryotic cervical smear results is likely to be cost effective. The predicted increase in lifetime colposcopies, however, deserves careful consideration.
Authors:
Rosa Legood; Alastair Gray; Jane Wolstenholme; Sue Moss
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2006-01-06
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  332     ISSN:  1756-1833     ISO Abbreviation:  BMJ     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-13     Completed Date:  2006-01-27     Revised Date:  2013-06-07    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  England    
Other Details:
Languages:  eng     Pagination:  79-85     Citation Subset:  AIM; IM    
Affiliation:
Health Economics Research Centre, Department of Public Health, University of Oxford, Oxford OX3 7LF. rosa.legood@dphpc.ox.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Adult
Cervical Intraepithelial Neoplasia / economics,  prevention & control*,  virology
Costs and Cost Analysis
Cytological Techniques / economics,  methods
Female
Humans
Mass Screening / economics*,  standards,  utilization
Middle Aged
Papillomaviridae*
Patient Acceptance of Health Care / statistics & numerical data
Pilot Projects
Sensitivity and Specificity
State Medicine / economics
Tumor Virus Infections / economics,  prevention & control*
Uterine Cervical Neoplasms / economics,  prevention & control*,  virology
Vaginal Smears / economics,  statistics & numerical data
Comments/Corrections
Comment In:
BMJ. 2006 Jan 14;332(7533):61-2   [PMID:  16410556 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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