Related Experiment Video
Updated: May 21, 2026
08:20
Cell Block Preparation from Cytology Specimen with Predominance of Individually Scattered Cells
Published on: July 21, 2009
Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis
Esther W de Bekker-Grob1, Inge M C M de Kok, Johan Bulten
1Department of Public Health, Erasmus MC-University Medical Centre Rotterdam, Rotterdam, The Netherlands. e.debekker@erasmusmc.nl
Cancer Causes & Control : CCC
|June 19, 2012
Summary
Liquid-based cytology (LBC) for cervical cancer screening is cost-effective compared to conventional Papanicolaou (CP) smears only under specific conditions. These include minimal cost differences, higher LBC sensitivity, or a high rate of inadequate CP smears.
Area of Science:
- Gynecologic Oncology
- Health Economics
- Public Health Screening
Background:
- Liquid-based cytology (LBC) offers an alternative to conventional Papanicolaou (CP) smears for cervical cancer screening.
- Evaluating the cost-effectiveness of LBC is crucial for its widespread implementation.
- The Dutch NETHCON trial provides data for assessing these economic aspects.
Purpose of the Study:
- To conduct cost-effectiveness threshold analyses for manually screened ThinPrep LBC.
- To determine the conditions under which LBC is a cost-effective screening method compared to CP smears.
- To inform decisions regarding the adoption of LBC in cervical cancer screening programs.
Main Methods:
- Utilized the MISCAN-Cervix microsimulation model with data from 89,784 women in the Dutch NETHCON trial.
- Estimated costs and quality-adjusted life years (QALYs) gained for various EU screening schedules.
- Analyzed screening strategies including primary LBC or CP cytology and human papillomavirus (HPV) triage.
Main Results:
- Manual ThinPrep LBC is cost-effective if its cost per test is less than €3.2 higher than CP.
- Cost-effectiveness is also achieved if LBC sensitivity is 3-5% points higher than CP.
- Alternatively, LBC is cost-effective if the quality of life in triage follow-up is low (0.39) or inadequate CP smear rates are at least 16.2%.
Conclusions:
- The transition from CP to manually screened ThinPrep LBC is cost-effective only under specific cost and performance criteria.
- If these conditions are not met, LBC implementation requires justification based on non-economic advantages.
- Further research is necessary to evaluate the cost-effectiveness of alternative LBC systems.
