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Cost-effectiveness of extending cervical cancer screening intervals among women with prior normal pap tests.

Publication ,  Journal Article
Kulasingam, SL; Myers, ER; Lawson, HW; McConnell, KJ; Kerlikowske, K; Melnikow, J; Washington, AE; Sawaya, GF
Published in: Obstet Gynecol
February 2006

OBJECTIVE: Annual cervical cancer screening in women with many prior normal Pap tests is common despite limited evidence on the cost-effectiveness of this strategy. We estimated the cost-effectiveness of screening women with 3 or more prior normal tests compared with screening those with no prior tests. METHODS: We used a validated cost-effectiveness model in conjunction with data on the prevalence of biopsy-proven cervical neoplasia in women enrolled in the Centers for Disease Control and Prevention National Breast and Cervical Cancer Early Detection Program. Women were grouped according to age at the final Program Pap test (aged < 30, 30-44, 45-59, and 60-65 years) and by screening history (0, 1, 2, and 3+ consecutive prior normal Program tests) to estimate cost per life-year and quality-adjusted life-year associated with annual, biennial, and triennial screening. RESULTS: For women aged 30-44 years with no prior tests, incremental cost-effectiveness ratios ranged from 20,533 US dollars for screening triennially (compared with no further screening) to 331,837 US dollars for screening annually (compared with biennially) per life-year saved. Among same-aged women with 3 or more prior normal Program tests, incremental cost-effectiveness ratios for the same measures ranged from 60,029 US dollars to 709,067 US dollars per life-year saved. Inclusion of the most conservative utility estimates resulted in incremental cost-effectiveness ratios in excess of 100,000 US dollars per quality-adjusted life-year saved associated with annual screening of same-aged women with 3 or more prior normal tests compared with biennial screening. CONCLUSION: As the number of prior normal Pap tests increases, the costs per life-year saved increase substantially. Resources should be prioritized for screening those never or rarely screened women. LEVEL OF EVIDENCE: II-2.

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Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

February 2006

Volume

107

Issue

2 Pt 1

Start / End Page

321 / 328

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Time Factors
  • Quality-Adjusted Life Years
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Humans
  • Female
  • Cost-Benefit Analysis
  • Aged
  • Adult
 

Citation

APA
Chicago
ICMJE
MLA
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Kulasingam, S. L., Myers, E. R., Lawson, H. W., McConnell, K. J., Kerlikowske, K., Melnikow, J., … Sawaya, G. F. (2006). Cost-effectiveness of extending cervical cancer screening intervals among women with prior normal pap tests. Obstet Gynecol, 107(2 Pt 1), 321–328. https://doi.org/10.1097/01.AOG.0000196500.50044.ce
Kulasingam, Shalini L., Evan R. Myers, Herschel W. Lawson, K John McConnell, Karla Kerlikowske, Joy Melnikow, A Eugene Washington, and George F. Sawaya. “Cost-effectiveness of extending cervical cancer screening intervals among women with prior normal pap tests.Obstet Gynecol 107, no. 2 Pt 1 (February 2006): 321–28. https://doi.org/10.1097/01.AOG.0000196500.50044.ce.
Kulasingam SL, Myers ER, Lawson HW, McConnell KJ, Kerlikowske K, Melnikow J, et al. Cost-effectiveness of extending cervical cancer screening intervals among women with prior normal pap tests. Obstet Gynecol. 2006 Feb;107(2 Pt 1):321–8.
Kulasingam, Shalini L., et al. “Cost-effectiveness of extending cervical cancer screening intervals among women with prior normal pap tests.Obstet Gynecol, vol. 107, no. 2 Pt 1, Feb. 2006, pp. 321–28. Pubmed, doi:10.1097/01.AOG.0000196500.50044.ce.
Kulasingam SL, Myers ER, Lawson HW, McConnell KJ, Kerlikowske K, Melnikow J, Washington AE, Sawaya GF. Cost-effectiveness of extending cervical cancer screening intervals among women with prior normal pap tests. Obstet Gynecol. 2006 Feb;107(2 Pt 1):321–328.
Journal cover image

Published In

Obstet Gynecol

DOI

ISSN

0029-7844

Publication Date

February 2006

Volume

107

Issue

2 Pt 1

Start / End Page

321 / 328

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Time Factors
  • Quality-Adjusted Life Years
  • Obstetrics & Reproductive Medicine
  • Middle Aged
  • Humans
  • Female
  • Cost-Benefit Analysis
  • Aged
  • Adult