PMID: 11339934May 8, 2001Paper

Impact of increasing Papanicolaou test sensitivity and compliance: a modeled cost and outcomes analysis

Obstetrics and Gynecology
F J MontzT Cornelison

Abstract

To model the impact of increasing screening compliance or implementing liquid-based cytology in populations with known compliance patterns and risk profiles on rates of detection of cervical precancers. An adaptation of a time-varying Markov model was used to follow a theoretic cohort of 100,000 women from age 20 through age 80. Separate analyses of all women, white, and black women were completed using three compliance rates (self-reported, Healthy People 2000, and Healthy People 2010 compliance) and two Papanicolaou test sensitivities (conventional Papanicolaou smear and liquid-based cytology). All populations benefited from both increased compliance and liquid-based cytology use. Increasing compliance to Healthy People 2010 goals resulted in 23%, 21.7%, and 17% reductions in cervical cancer incidence for all women, white, and black women, respectively. Substituting liquid-based cytology for traditional Papanicolaou smear collection and processing with no change in compliance resulted in 32%, 32%, and 33% reductions in cervical cancer incidence for the same three subpopulations. In addition, cost-effectiveness of the liquid-based technology indirectly related to the risk profile of the population: for black women, the cost-ef...Continue Reading

References

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Citations

Sep 5, 2002·Cancer·Terence J ColganAllan Seidenfeld
Mar 30, 2004·Gynecologic Oncology·Michael R ManuelLeslee L Subak
Aug 23, 2002·Current Opinion in Oncology·Anne T O'Meara
May 6, 2005·Journal of Lower Genital Tract Disease·Diane D Davey
Feb 6, 2007·International Journal of Gynaecology and Obstetrics : the Official Organ of the International Federation of Gynaecology and Obstetrics·Sue Goldie
Sep 5, 2006·Vaccine·Sue J GoldieEvan Myers
Apr 10, 2002·American Journal of Clinical Pathology·Stephen S RaabEugene Scioscia
Apr 22, 2006·American Journal of Obstetrics and Gynecology·Judy M LeeDouglas P Clark
Aug 6, 2004·American Journal of Obstetrics and Gynecology·Ralph P InsingaBrenda B Rush
Sep 7, 2004·Diagnostic Cytopathology·Maria Lúcia UtagawaAdhemar Longatto Filho
Apr 10, 2002·American Journal of Clinical Pathology·Diane D Davey
Dec 16, 2006·Qualitative Health Research·Mira L KatzElectra D Paskett
Jun 17, 2003·Journal of the National Cancer Institute. Monographs·Sue J Goldie
Jan 2, 2003·Obstetrics and Gynecology Clinics of North America·Steven A Vasilev

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