<p>Cost-Effectiveness and Cost-Benefit of Cervical Cancer Screening with Liquid Based Cytology Compared with Conventional Cytology in Germany</p>

Abstract Objective Liquid-based cytology has replaced conventional cytology in cervical cancer screening in many countries. However, a detailed comparison of liquid-based cytology with conventional cytology has not been reported in Japan. Therefore, the aim of the study is to evaluate efficacy of liquid-based cytology in Japan. Methods We first evaluated the prevalence of use of liquid-based cytology and then examined the efficacy of liquid-based cytology and conventional cytology for detecting CIN and the rate of unsatisfactory specimens using data from cancer screening collected by the Japanese Cancer Society from FY2011 to FY2014. A Poisson regression model with random effects analyses was used to classify histological outcomes and unsatisfactory specimens using liquid-based cytology compared to conventional cytology. Results A total of 3 815 131 women were analyzed in the study. The rate of liquid-based cytology increased from approximately 8% in FY2011 to 37% in FY2014. Compared to conventional cytology, the detection rates with liquid-based cytology were significantly higher (1.42 times) for CIN1+ [detection rate ratio (DRR) = 1.42, 95% confidence interval (CI) 1.35–1.48, P < 0.001] and CIN2+ (DRR = 1.16, 95% CI 1.08–1.25, P < 0.001). Positive predictive value ratios of CIN1+ and CIN2+ were also significantly higher for liquid-based cytology than for conventional cytology. However, there was no significant difference between liquid-based cytology and conventional cytology for detection rates and positive predictive values of CIN3+ and cancer. The rate of unsatisfactory specimens was significantly lower with liquid-based cytology compared to conventional cytology (DRR = 0.07, 95% CI 0.05–0.09, P < 0.001). Conclusions In order to avoid the unsatisfactory specimens in cervical cancer screening, the results of this study did indicate that liquid-based cytology was more useful than conventional cytology in practical standpoints.

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Liquid-based Cytology With HPV Triage of Low-grade Cytological Abnormalities Versus Conventional Cytology in Cervical Cancer Screening

Current Pharmaceutical Design ◽

10.2174/1381612811319080007 ◽

2013 ◽

Vol 19 (8) ◽

pp. 1406-1411

Author(s):

Maria Froberg ◽

Ingrid Norman ◽

Bo Johansson ◽

Anders Hjerpe ◽

Elisabete Weiderpass ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Low Grade ◽

Conventional Cytology ◽

Cytological Abnormalities ◽

Liquid Based Cytology

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Cost-Effectiveness Analysis of Liquid-Based Cytology and Human Papillomavirus Testing in Cervical Cancer Screening

Obstetrics and Gynecology ◽

10.1097/01.aog.0000210529.70226.0a ◽

2006 ◽

Vol 107 (5) ◽

pp. 997-1005 ◽

Cited By ~ 25

Author(s):

Michael A. Bidus ◽

G Larry Maxwell ◽

Shalini Kulasingam ◽

G Scott Rose ◽

John C. Elkas ◽

...

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Cost Effectiveness Analysis ◽

Human Papillomavirus Testing ◽

Effectiveness Analysis ◽

Liquid Based Cytology

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Liquid-based Cytology With HPV Triage of Low-grade Cytological Abnormalities Versus Conventional Cytology in Cervical Cancer Screening

Current Pharmaceutical Design ◽

10.2174/138161213804805603 ◽

2013 ◽

Vol 19 (8) ◽

pp. 1406-1411

Author(s):

Maria Froberg ◽

Ingrid Norman ◽

Bo Johansson ◽

Anders Hjerpe ◽

Elisabete Weiderpass ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Low Grade ◽

Conventional Cytology ◽

Cytological Abnormalities ◽

Liquid Based Cytology

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Comparative evaluation of conventional cytology and a low-cost liquid-based cytology technique, EziPREP™, for cervicovaginal smear reporting: A split sample study

CytoJournal ◽

10.4103/cytojournal.cytojournal_11_19 ◽

2019 ◽

Vol 16 ◽

pp. 22

Author(s):

Ruchika Gupta ◽

Ravi Yadav ◽

Akhileshwar Sharda ◽

Dinesh Kumar ◽

Sandeep ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Low Cost ◽

Low Grade ◽

Cervical Lesions ◽

Widespread Application ◽

Conventional Cytology ◽

Split Sample ◽

Liquid Based Cytology

Background: Liquid-based cytology (LBC) for cervical cancer screening offers several advantages over conventional cytology. However, the extremely high cost of the current approved devices precludes widespread application of LBC technique in resource-constrained countries. This study aimed to evaluate the performance of an indigenous low-cost LBC technique, EziPREP™ (EP), against conventional preparations (CPs) for cervical cancer screening. Materials and Methods: A cross-sectional split-sample study with consecutive cervical sampling was conducted on 515 women attending the clinic at our institute. CP smears were prepared as per the standard technique using spatula and endocervical brush followed by detaching the head of brush into the fixative vial of EP. The EP samples were processed as per the manufacturer's protocol. Both CP and EP smears were stained using standard Papanicolaou stain protocol. Both sets of smears were evaluated for staining quality, morphologic details, and cytologic diagnoses. Cytologic diagnoses were correlated with cervical biopsy findings, wherever available. Performance characteristics of the two techniques were calculated. Results: The unsatisfactory rate for CP was 1.0%, while on EP, 1.3% smears had inadequate cellular material. The staining quality and morphological details were comparable in both sets of smears. The detection of infections and epithelial cell abnormality was more, though not statistically significant in EP smears. There was a 98% concordance in cytologic diagnosis between CP and EP smears. Cytohistologic concordance was observed in 96% of cases for both CP and EP smears. Although the time taken for processing and staining of smears was higher for EP (2.5 min for EP per smear and 1.6 min for CP per smear), the screening time reduced from 6.5 min per smear for CP to 2.2 min in EP smears. Conclusion: EP provides monolayered cervical smears with vivid morphological details, leading to reduced screening time and relatively higher pick-up of infections and low-grade cervical lesions as compared to conventional smears. The availability of such low-cost devices may enable wider application of cytology-based cervical cancer screening in low-resource countries.

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Cost effectiveness analysis of cervical cancer screening in women until age 70

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20184111 ◽

2018 ◽

Vol 7 (10) ◽

pp. 3899

Author(s):

James C. Quon

Keyword(s):

Cervical Cancer ◽

Sensitivity Analysis ◽

Cost Effectiveness ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

Task Force ◽

Cost Benefit ◽

Cost Effective ◽

The United States ◽

Screening Guidelines

Background: 2017 US Preventive Services Task Force guidelines for screening cervical cancer and pre-malignant lesions advise that screenings cease for women over age 65, with qualifications. Recent literature has identified significant discrepancies in rates of cervical cancer in older women – if hysterectomies in this patient population is accounted for, cervical cancer incidence does not decline with age as previously established. This adjusted incidence of cervical cancer necessitates a re-examination of current practice.Methods: This study seeks to demonstrate the utility of extending the cervical cancer screening age recommendations to age 70. Cost effectiveness will be estimated, from a payer perspective, of extending screening to age 70 for the United States women’s population in those who have not undergone hysterectomy or otherwise been treated for past cervical cancer or premalignancy. A Markov model was constructed to project outcomes in a hypothetical cohort of 10 000 women aged 65 to 70, with a time horizon of lifetime. A Probability Sensitivity Analysis determined the robustness of the result, and the Incremental Cost-effectiveness Ratio (ICER) is charted.Results: The economic evaluation of screening compared to none in this population was determined to be cost effective, with an ICER demonstrating a cost benefit, and Quality Adjusted Life Year (QALY) benefit, to extended screening.Conclusions: The sensitivity analysis confirms the robustness of this result. Implementing extended screening guidelines could potentially be a significant gain for both patients and society.

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