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01.08.2012 | Original paper

Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis

verfasst von: Esther W. de Bekker-Grob, Inge M. C. M. de Kok, Johan Bulten, Joost van Rosmalen, Judith E. M. Vedder, Marc Arbyn, Paul J. J. M. Klinkhamer, Albertus G. Siebers, Marjolein van Ballegooijen

Erschienen in: Cancer Causes & Control | Ausgabe 8/2012

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Abstract

Purpose

Cervical cancer screening with liquid-based cytology (LBC) has been developed as an alternative to the conventional Papanicolaou (CP) smear. Cost-effectiveness is one of the issues when evaluating LBC. Based on the results of a Dutch randomised controlled trial, we conducted cost-effectiveness threshold analyses to investigate under what circumstances manually screened ThinPrep LBC is cost-effective for screening.

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.

Results

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 %.

Conclusions

Regarding test characteristics and costs of LBC and 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. Further research is needed to establish whether other LBC systems will be more favorable with regard to cost-effectiveness.

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Titel: Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis
verfasst von: Esther W. de Bekker-Grob
Inge M. C. M. de Kok
Johan Bulten
Joost van Rosmalen
Judith E. M. Vedder
Marc Arbyn
Paul J. J. M. Klinkhamer
Albertus G. Siebers
Marjolein van Ballegooijen
Publikationsdatum: 01.08.2012
Verlag: Springer Netherlands
Erschienen in: Cancer Causes & Control / Ausgabe 8/2012
Print ISSN: 0957-5243
Elektronische ISSN: 1573-7225
DOI: https://doi.org/10.1007/s10552-012-0011-1

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Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis