Authors' objectives:

The objective of this HTA is to perform an evidence-based evaluation of conventional pap smear (CPS) compared with liquid based cytology (LBC) and to describe the consequences of using these methods in a Danish context, including consequences related to automatized screening and human papillomavirus (HPV) testing. Furthermore, patient-related, organizational and economic consequences are explored.

Authors' recommendations: Main conclusions: 1. That no scientific basis has been found to suggest any difference in clinical or health economic effect between liquid based cytology (LBC) and conventional Pap smear (CPS). 2. If the objective is to improve the clinical or health economic effectiveness, the report demonstrates that an increased coverage rate and an expansion of the age interval included in screening programmes for cancer of the uterine cervix from 59 to 69 years of age would be the more efficient strategy. The following section provides an outline of primary part conclusions: 1. More samples with cellular changes are detected with LBC than with CPS. 2. Fewer inadequate cell samples result from LBC than from CPS. 3. For the women concerned any detection of cellular changes entails further examination, which in many cases proves to be unnecessary. 4. Expenses derived from employing either CPS or LBC are identical. Most CPS expenses are personnel costs whereas the major part of LBC costs are related to utensils. 5. The health economic analysis shows that CPS in combination with automatic screening and guided (semiautomatic) screening is the more inexpensive solution. 6. There is a need for consistent classification, encoding and follow-up standards for women with abnormal cell samples. Inconsistent practice in Danish counties may be improved through coordinated and concerted regional and national efforts. 7. The effectiveness of screening programmes may be increased by minimizing general practitioners' and specialists' use of cell samples with no connection to the screening programmes (opportunistic cell samples).

Authors' methods: Review

Project Status: Completed

Year Published: 2005

URL for published report: http://www.sst.dk/publ/Publ2006/CEMTV/Cervix/Cervix.pdf

URL for additional information: http://www.sst.dk/publ/Publ2006/CEMTV/Cervix/Cervix_UKsum.pdf

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Denmark

Organisation Name: Danish Centre for Evaluation and Health Technology Assessment

Contact Address: National Board of Health, PO Box 1881, Islands Brygge 67, DK-2300 Copenhagen S, Denmark. Tel: 45 72 22 74 48; Fax: 45 72 22 74 07/67

Contact Name: dacehta@sst.dk

Contact Email: dacehta@sst.dk

Copyright: Danish Centre for Evaluation and Health Technology Assessment (DACEHTA)