Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis
Cancer Causes and Control, 06/22/2012
de Bekker–Grob EW et al. – Regarding test characteristics and costs of liquid–based cytology (LBC) and conventional Papanicolaou (CP), only under certain conditions will a change from CP to manually screened ThinPrep LBC be cost–effective. If none of these conditions are met, implementation of manually screened ThinPrep LBC seems warranted only if there are advantages other than cost–effectiveness.Methods
- The MISCAN-Cervix microsimulation model and data from the Dutch NETHCON trial (including 89,784 women) were used to estimate the costs and (quality-adjusted) life years ((QA)LYs) gained for EU screening schedules, varying cost-effectiveness threshold values.
- Screening strategies were primary cytological screening with LBC or CP, and triage with human papillomavirus (HPV) testing.
- Threshold analyses showed that screening with LBC as a primary test can be cost-effective if LBC is less than €3.2 more costly per test than CP, if the sensitivity of LBC is at least 3–5 % points higher than CP, if the quality of life for women in triage follow-up is only 0.39, or if the rate of inadequate CP smears is at least 16.2 %.