J Public Health Med. 1999 Jun;21(2):140-4.
Cervical screening interval: costing the options in one health authority.
Authors:
Grant CM.
Division of Primary Health Care, Bristol.
Background:
This is a study of the costs of the cervical screening programme in one health authority with a mixed three and five year, and thus ine quitable, cervical screening interval. The costs of three year and five yearly screening are compared, and considered in terms of likely numbers of averted cases of and deaths from cervical cancer.
Methods:
The study uses an activity-based costing procedure to calculate the component and total costs of the cervical screening programme.
Results:
The main costs of the cervical screening programme are the costs of taking and processing smears. In 1994-1995 the total cost of a three year recall policy was 768 570 pound silver per 100000 eligible women and that of a five year recall policy was 476768 pound silver per 100000 eligible women. Best estimates of the numbers of cases of and deaths from invasive cervical cancer averted by three over five yearly screening are 1.4 and 0.7 per 100000 eligible women, respectively. Because of uncertainty regarding colposcopy costs a sensitivity analysis was carried out, giving a range of cost differences between three and five yearly screening of 278477 pound silver and 351 768 pound silver.
Conclusions:
The health service costs of three yearly screening are considerably greater than those of five yearly screening. Despite this, a significant proportion of smear-takers are screening more frequently than five yearly, with implications for anxiety of screened women, as well as health service costs.
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- 1 What is cancer (malignancy)
- 2 What is meant by cancer staging?
- 3 How prevalent is cancer?
- 4 How prevalent are womens' cancers?
- 5 What causes cancer?
- 6 Is cancer a hereditary condition?
- 7 How can gynaecological cancer present?
- 8 How can we reduce the risks of the womens' cancers?
Reducing the Risks of Womens' Cancers.
- 9 What are screening tests?
- 10 What are the reactions to a diagnosis of cancer?
- 11 Is there a place for counselling when cancer is diagnosed?
- 12 Can personality alter the prognosis?
- 13 Is the incidence of deaths from the female cancers changing?
- 14 Is there a place for a holistic approach to cancer?
Cancer of the Cervix.
- 15 How prevalent is cervical cancer?
- 16 What causes cervical cancer?
- 17 How long an interval should there be between cervical screening (smear) (PAP) tests?
- 18 Is there any evidence that cervical screening can reduce the incidence of cervical cancer?
- 19 Will pre-malignant changes of the cervix invariably lead to cancer?
Endometrial Cancer (Uterus)
- 20 What causes endometrial cancer?
- 21 Are there screening tests for endometrial cancer?
- 22 How does endometrial cancer present?
- 22a How can endometrial cancer be prevented?
- 22b How can endometrial cancer be treated?
Cancer of the Ovary.
- 23 How does ovarian cancer present?
- 24 How prevalent is ovarian cancer?
- 25 What are tumour markers?
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- 27 What is the relationship between infertility and ovarian cancer?
- 28 Can treatment of infertility increase the risk of ovarian cancer?
- 29 What is the relationship between oral contraception and cancer?
- 30 Can ovarian cancer be prevented?
- 31 I use talcum power. Could this increase my risk of developing ovarian cancer?
The Treatment Of Womens' Cancers
- 32 Can we predict the course of a cancer?
- 33 What treatment options are available for gynaecological cancer?
- Q32.33c What treatment options are available for ovarian cancer?
Cancer of the Vulva, Vagina and Fallopian Tube
- 34 How prevalent are malignant conditions of the vulva, vagina and Fallopian tubes?
Breast Cancer
- 35 What is the incidence of breast cancer?
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- 35a What are the advantages of breast cancer screening - mammography - mammograms?
- 14 Is there a place for a holistic approach to cancer?
- 36 How often should breast screening be carried out?
- 37 Are there any problems having a mammogram?
- 38 Should I check myself for breast lumps?
- 39 One of my family developed cancer of the breast. Am I at increased risk?
- 40 We have a family tendency towards developing breast / ovarian cancer. Are there any genetic tests to find out if I am at increased risk?
- 41 What happens if a mammogram shows an abnormality?
- 42 What are the advantages and disadvantages of tamoxifen in the management of breast cancer?
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Web sites and Support Groups
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