Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis

Bekker‐Grob, Esther W. de; Kok, Inge M.C.M. de; Bulten, Johan; Rosmalen, Joost van; Vedder, Judith E. M.; Arbyn, Marc; Klinkhamer, Paul J. J. M.; Siebers, Albertus G.; Ballegooijen, Marjolein van

doi:10.1007/s10552-012-0011-1

Cited by 26 publications

(21 citation statements)

References 31 publications

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“…A study by Taylor et al 20 found that a commonly used LBC product reduced the number of inadequate smears but did not improve detection of histology-confirmed disease (cervical intraepithelial neoplasia grade 1 or worse) and therefore concluded that the increased cost does not justify the implementation of LBC. In contrast, a review by Cox 21 showed that LBC was cost-effective. A study by de Bekker-Grob et al 22 similarly determined that LBC can be cost-effective as a cervical screening modality, specifically if the cost of LBC exceeded the cost of conventional cytology by less than €3.2, the sensitivity of LBC was at least 3% – 5% greater than conventional cytology and the rate of inadequate smears on conventional cytology was at least 16.2%.…”

Section: Discussionmentioning

confidence: 93%

Performance of the Cellslide® automated liquid-based cytology system amongst HIV-positive women

et al. 2016

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BackgroundMany women undergoing cervical screening as part of a national South African screening programme may be positive for HIV. The performance of liquid-based cytology (LBC) on samples from HIV-positive women needs to be determined.ObjectivesThe performance of the Cellslide® automated LBC system was evaluated as a possible alternative to conventional cytology in a national cervical cancer screening programme.MethodsSplit samples from 348 HIV-positive women attending an HIV treatment clinic in Johannesburg, South Africa were examined by conventional cytology and monolayer LBC methods. All samples were stained, examined and reported in the same manner. Cytotechnologists were blinded to the conventional smear diagnosis if the LBC smear was screened and vice versa.ResultsThe same percentage of inadequate smears (1.4%) was obtained by conventional cytology and LBC. Atypical squamous cells of undetermined significance were observed in 5.2% of conventional smears and 4.0% of LBC smears. Low-grade squamous intraepithelial lesions were found in 35.6% of conventional smears and 32.7% of LBC smears. Only one conventional smear was categorised as atypical squamous cells – cannot exclude a high-grade lesion, whereas five such cases were identified on LBC. High-grade squamous intraepithelial lesions were seen in 21.6% of conventional smears and 23.3% LBC smears. No invasive carcinoma was identified.ConclusionThe performance of the Cellslide® LBC system was similar to that of conventional cytology in this population of high-risk HIV-positive women, indicating that it may be introduced successfully as part of a cervical cancer screening programme.

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Section: Discussionmentioning

confidence: 93%

Performance of the Cellslide® automated liquid-based cytology system amongst HIV-positive women

et al. 2016

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“…The findings from our study are consistent with those reported in an Australian 31 and UK study. 32 However, they contradict the findings from studies conducted in The Netherlands 33 and France. 34 NICE approved LBC for use within the UK's National Health Service (NHS).…”

Section: Discussionmentioning

confidence: 85%

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

Armstrong¹,

Guest²

2020

CEOR

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Objective: To assess the health economic impact of cervical screening with liquid based cytology (LBC) compared with conventional cytology (CC) in Germany.Methods: An economic model was constructed depicting the management of a hypothetical cohort of women aged ≥20 years who undergo cervical screening in Germany. The model estimated the cost-effectiveness and cost-benefit of LBC compared with CC at 2017/18 prices over a time-horizon of 70 years. Results: Performing cervical screens with LBC instead of CC is expected to increase the probability of detecting a true positive over a subject's lifetime by 73% (0.038 versus 0.022) and of diagnosing a subject with stage 3 cervical intraepithelial neoplasia (CIN3) (0.019 versus 0.011). Women screened with LBC instead of CC are expected to have a 57% reduction in the probability of having undetected CIN3 (0.006 versus 0.014) and to experience a 44% reduction in the probability of transitioning into disease progression (from 0.018 to 0.010). The mean discounted lifetime cost of healthcare resource use associated with performing cervical screens with LBC and CC was estimated at €4852 and €7523 per subject respectively. For every Euro invested in cervical screening with LBC instead of CC, the German healthcare system could potentially save~€170 over a subject's lifetime. Conclusion: Within the study's limitations, the analysis showed that LBC affords a costeffective cervical screening test compared with CC in Germany, since it improves detection rates and has the potential to lead to a reduction in disease progression for less cost. ClinicoEconomics and Outcomes Research Dovepressopen access to scientific and medical research Open Access Full Text Article submit your manuscript | www.dovepress.com ClinicoEconomics and Outcomes Research 2020:12 153-166

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“…In 2004, Ferraz et al compared the results of pap smear test with liquid-based cytology over 800 women. They reported the sensitivity and specificity of liquid based system for detection of cervical intraepithelial lesions and cancer were 75.3% and 86.4%, respectively, not statistically different from the 81.8% and 85.2% seen with the conventional method (19).…”

Section: Discussionmentioning

confidence: 92%

Is liquid-based cervical cytology test more effective than conventional pap smear?

Alkan-Kuşabbi¹,

Aydoğmuş²,

Işık³

et al. 2017

Electron J Gen Med

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Objective: To evaluate and compare the efficiencies of cytologic test methods conventional Pap smear (CVS) versus Thin Prep liquid-based cytology technique (TPT) in the histologic diagnosis of the precancerous lesions of the cervix and cervical cancer. Materials and Methods:We selected randomly 1203 non-gravid women who were admitted to gynecology and menopause out-patient clinics of our hospital in the study. The cervical smear tests of all women were evaluated both using the conventional Pap smear and the TPT. Cytological examinations were compared according to their adequacy for evaluation. The evaluation of samples were performed and compared according to The Bethesda System. Results: The two screening methods were statistically compatible for evaluating the samples (κ=0,379 and p<0,001). The diagnosis interpreted by CPS and TPT methods were synchronous and this was also statistically significant (ĸ=0,829 ve p<0,001). Conclusion: Our cytohistologic diagnoses and samples' adequacy interpreted with CVS and TPT were statistically significantly synchronous.

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Liquid-based cervical cytology using ThinPrep technology: weighing the pros and cons in a cost-effectiveness analysis

Cited by 26 publications

References 31 publications

Performance of the Cellslide<sup>®</sup> automated liquid-based cytology system amongst HIV-positive women

Performance of the Cellslide<sup>®</sup> automated liquid-based cytology system amongst HIV-positive women

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

Is liquid-based cervical cytology test more effective than conventional pap smear?

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