| Lifetime effects, costs, and cost effectiveness of testing for human papillomavirus to manage low grade cytological abnormalities: results of the NHS pilot studies. | |
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MedLine Citation:
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PMID: 16399769 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Rosa Legood; Alastair Gray; Jane Wolstenholme; Sue Moss |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't Date: 2006-01-06 |
Journal Detail:
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Title: BMJ (Clinical research ed.) Volume: 332 ISSN: 1756-1833 ISO Abbreviation: BMJ Publication Date: 2006 Jan |
Date Detail:
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Created Date: 2006-01-13 Completed Date: 2006-01-27 Revised Date: 2012-03-06 |
Medline Journal Info:
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Nlm Unique ID: 8900488 Medline TA: BMJ Country: England |
Other Details:
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Languages: eng Pagination: 79-85 Citation Subset: AIM; IM |
Affiliation:
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Health Economics Research Centre, Department of Public Health, University of Oxford, Oxford OX3 7LF. rosa.legood@dphpc.ox.ac.uk |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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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:
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BMJ. 2006 Jan 14;332(7533):61-2
[PMID:
16410556
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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