Cost-effectiveness of rescreening conventionally prepared cervical smears by PAPNET testing

OBJECTIVE: This study explored the cost-effectiveness of the use of PAPNET testing�supplemental, neural network�based testing used to increase the accuracy of cervical smear screening practice. STUDY DESIGN: Using a model adapted from one developed under contract from the United States Congress Office of Technology Assessment to evaluate costeffectiveness of cervical cancer screening in elderly women, the study evaluated U.S. women aged 20�64. The study reviewed various screening intervals and examined the course of followup (i.e., repeat abnormal smear vs. immediate colposcopy) to offer a range into which most routine medical practice will fall. RESULTS: Assuming a false negative rate of 25% for low grade squamous intraepithelial lesion (SIL) and 15% for high grade SIL and applying increased sensitivity of 30% from PAPNET, we can expect a cost of $48,474 per life-year saved among biennially screened women. For women screened triennially, as recommended by most groups, the cost per life-year saved is $25,185. CONCLUSION: The PAPNET rescreening program is an economical approach to decreasing mortality and morbidity from cervical cancer and compares favorably to other commonly used interventions and diagnostic procedures.