Skip to main content
Journal cover image

Cost analysis of colposcopy for abnormal cytology in post-treatment surveillance for cervical cancer.

Publication ,  Journal Article
Tergas, AI; Havrilesky, LJ; Fader, AN; Guntupalli, SR; Huh, WK; Massad, LS; Rimel, BJ
Published in: Gynecol Oncol
September 2013

OBJECTIVE: The aim of this study was to estimate cost and outcomes associated with colposcopy following abnormal Pap for women with a history of cervical cancer. METHODS: Decision models compared the costs and number of isolated local recurrences (ILR) detected using two strategies, colposcopy and no colposcopy, for women with a history of cervical cancer and low grade or high grade Pap. Clinical data for input were derived from a cohort of women with a history of cervical cancer undergoing surveillance Paps at 2 institutions. Costs were obtained using national reimbursement data. RESULTS: Five hundred fifty-six patients underwent 2900 surveillance Paps. Twenty-seven of 50 women with a low grade Pap underwent colposcopy. One of 3 recurrences in the colposcopy group was an ILR diagnosed colposcopically. Colposcopy following low grade Pap costs $354 more and resulted in a lower rate of diagnosis of ILR compared to no colposcopy (3.7% vs 8.6%). Sixty of 78 women with a high grade Pap underwent colposcopy. Three of 15 recurrences in the colposcopy group were ILR diagnosed colposcopically. Colposcopy following high grade Pap costs $623 more than no colposcopy but resulted in a higher rate of diagnosis of ILR (5% vs 0%; $7481 per additional ILR). CONCLUSIONS: Colposcopy following low or high grade surveillance Pap smear adds substantial cost to the management of women with cervical cancer. Only colposcopy following a high grade Pap is associated with a higher probability that cervical cancer recurrence will be detected when salvageable. These findings support withholding colposcopy for abnormal surveillance Pap tests less than high grade.

Duke Scholars

Altmetric Attention Stats
Dimensions Citation Stats

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

September 2013

Volume

130

Issue

3

Start / End Page

421 / 425

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Papanicolaou Test
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Neoplasm Grading
  • Humans
  • Female
  • Decision Support Techniques
  • Cost-Benefit Analysis
 

Citation

APA
Chicago
ICMJE
MLA
NLM
Tergas, A. I., Havrilesky, L. J., Fader, A. N., Guntupalli, S. R., Huh, W. K., Massad, L. S., & Rimel, B. J. (2013). Cost analysis of colposcopy for abnormal cytology in post-treatment surveillance for cervical cancer. Gynecol Oncol, 130(3), 421–425. https://doi.org/10.1016/j.ygyno.2013.05.037
Tergas, Ana I., Laura J. Havrilesky, Amanda N. Fader, Saketh R. Guntupalli, Warner K. Huh, L Stewart Massad, and B. J. Rimel. “Cost analysis of colposcopy for abnormal cytology in post-treatment surveillance for cervical cancer.Gynecol Oncol 130, no. 3 (September 2013): 421–25. https://doi.org/10.1016/j.ygyno.2013.05.037.
Tergas AI, Havrilesky LJ, Fader AN, Guntupalli SR, Huh WK, Massad LS, et al. Cost analysis of colposcopy for abnormal cytology in post-treatment surveillance for cervical cancer. Gynecol Oncol. 2013 Sep;130(3):421–5.
Tergas, Ana I., et al. “Cost analysis of colposcopy for abnormal cytology in post-treatment surveillance for cervical cancer.Gynecol Oncol, vol. 130, no. 3, Sept. 2013, pp. 421–25. Pubmed, doi:10.1016/j.ygyno.2013.05.037.
Tergas AI, Havrilesky LJ, Fader AN, Guntupalli SR, Huh WK, Massad LS, Rimel BJ. Cost analysis of colposcopy for abnormal cytology in post-treatment surveillance for cervical cancer. Gynecol Oncol. 2013 Sep;130(3):421–425.
Journal cover image

Published In

Gynecol Oncol

DOI

EISSN

1095-6859

Publication Date

September 2013

Volume

130

Issue

3

Start / End Page

421 / 425

Location

United States

Related Subject Headings

  • Vaginal Smears
  • Uterine Cervical Neoplasms
  • Papanicolaou Test
  • Oncology & Carcinogenesis
  • Neoplasm Recurrence, Local
  • Neoplasm Grading
  • Humans
  • Female
  • Decision Support Techniques
  • Cost-Benefit Analysis