Impact of automated technology on the cervical cytologic smear. A comparison of cost

The cervical cytologic screening test for cervical cancer is the largest-volume cancer screening test currently conducted predominantly without the advantage of process automation. Much attention has been directed toward commercial application of automated technology to support both quality enhancement and productivity gain in cervical cytology screening. Several systems are now available for clinical application that address various aspects of cervical cytologic screening automation. These include specimen-preparation devices and image-based automated screeners. Each system provides a different mix of benefits and impacts cost differently as well. This, coupled with the fact that few systems are in broad clinical use as yet, makes it difficult to conduct parallel cost-benefit analysis. A comparison is presented on the impact of system use on the laboratory's cost to conduct the test. Although there is a demand for technology that can support improvements in quality and/or productivity of cervical cytologic screening, there is also a responsibility for fiscal prudence in technology implementation. Products that dramatically increase the cost of service, and thus perhaps limit access to care for some patients, may have an impact on patient outcomes quite apart from that intended.