Related Experiment Videos
Preventive Pap-smears: balancing costs, risks and benefits.
M van Ballegooijen1, J D Habbema, G J van Oortmarssen
1Department of Public Health and Social Medicine, Erasmus University Rotterdam, The Netherlands.
British Journal of Cancer
|June 1, 1992
Summary
Current cervical cancer screening practices in the Netherlands are inefficient. An optimized policy, screening women aged 30-60 every 5 years, saves lives, cuts costs, and reduces unnecessary treatments.
Area of Science:
- Public Health
- Gynecology
- Health Economics
Background:
- Current spontaneous cervical cancer screening by Dutch general practitioners and gynaecologists is compared against an evidence-based, cost-effective policy.
- Spontaneous screening patterns often lead to suboptimal outcomes, including premature cessation or excessive frequency of screening.
- The current approach results in both overscreening and underscreening, impacting effectiveness and patient safety.
Purpose of the Study:
- To compare the effectiveness and efficiency of current cervical cancer screening practices with an optimized screening policy.
- To evaluate the cost-effectiveness of a revised screening strategy for cervical cancer.
- To identify improvements in screening protocols to maximize life-saving benefits while minimizing costs and patient harm.
Main Methods:
- Comparative analysis of spontaneous screening patterns versus a cost-effectiveness study-derived policy.
- Evaluation of screening age ranges, intervals, and their impact on incidence and outcomes.
- Analysis of unnecessary referrals and treatments associated with current and proposed screening methods.
Main Results:
- Spontaneous screening often begins too early and ends too soon, failing to adequately protect women.
- A significant proportion of women are either overscreened or left unprotected by the current system.
- Screening between ages 30 and at least 60, with 5-year intervals, can save as many lives at half the cost.
- This optimized policy reduces unnecessary referrals and treatments by 60%.
Conclusions:
- The current spontaneous cervical cancer screening in the Netherlands is inefficient and potentially harmful.
- An optimized screening policy focusing on ages 30-60 with 5-year intervals offers significant improvements in cost-effectiveness and patient outcomes.
- Emphasis should be placed on achieving high coverage within the target population and restraining therapeutic follow-up for dysplastic lesions.