An analysis published in Annals of Internal Medicine shows that current U.S. cervical cancer screening practices are inefficient with respect to health benefits and costs, due to noncompliance with recommended guidelines. Additional investments in interventions may be needed to improve screening programs.
Cytology-based screening has led to substantial declines in cervical cancer incidence and mortality, yet screening practices vary widely. Inefficiencies in screening lead to increased economic burden and disease incidence, especially among underserved populations. Researchers created mathematical models to compare reductions in lifetime cervical cancer risks, quality-adjusted life-years, and costs using current cervical cancer screening practices to the same outcomes using guideline-based screening intervals (every 3 years), HPV triage testing, diagnostic referrals, and precancer treatment referrals.
In terms of cost-effectiveness, current screening practice remained inefficient in all simulations conducted, implying that although guidelines-based strategies are more costly, the gains in health are also relatively greater. The added health benefit of improving compliance with guidelines, especially the 3-year interval for cytologic screening and diagnostic follow-up, may justify additional investments in interventions to improve U.S. cervical cancer screening practice.
Research: Inefficiencies and High-Value Improvements in U.S. Cervical Cancer Screening Practice: A Cost-Effectiveness Analysis, Jane J. Kim, PhD; Nicole G. Campos, PhD; Stephen Sy, MS; Emily A. Burger, PhD; Jack Cuzick, PhD; Philip E. Castle, PhD, MPH; William C. Hunt, MS; Alan Waxman, MD, MPH; Cosette M. Wheeler, PhD, on behalf of the New Mexico HPV Pap Registry Steering Committee, Annals of Internal Medicine, doi:10.7326/M15-0420, published online 29 September 2015.