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The utility and cost-effectiveness of Pap test rescreening
1Department of Pathology, Allegheny University of Health Sciences, Allegheny General Hospital, Pittsburgh, PA, USA.
Clinical Laboratory Management Review : Official Publication of the Clinical Laboratory Management Association
|February 6, 1998
Summary
Manual rescreening of Pap tests is common, but a 10% strategy offers minimal life expectancy gains. 100% rescreening is more cost-effective than no rescreening when costs are low.
Area of Science:
- Gynecologic pathology
- Health economics
- Cancer screening
Background:
- Current practice involves 10% manual rescreening of negative Pap tests.
- The cost-effectiveness of Pap test rescreening strategies is not well-established.
Purpose of the Study:
- To evaluate the cost-effectiveness of various Pap test rescreening strategies compared to nonrescreening approaches.
Main Methods:
- A decision model was developed to compare rescreening versus nonrescreening strategies.
- The model assessed outcomes including false negatives/positives, cancer incidence, life expectancy, and cost-effectiveness.
Main Results:
- A 10% rescreening strategy showed negligible improvement in life expectancy over no rescreening.
- 100% rescreening strategies were found to be more cost-effective than no rescreening when rescreening costs ranged from $2 to $10 per patient.
Conclusions:
- Low-cost 100% rescreening strategies are more cost-effective than nonrescreening strategies for Pap tests.
- The findings suggest a shift towards comprehensive rescreening may be beneficial under specific economic conditions.