thesis
Effects and Costs of Cervical Cancer Screening
- Publication date
- 15 April 1998
- Publisher
- The objective of this thesis is to evaluate cervical eaueer screening by assessing
its various effects and costs. Questions to be addressed concern the rednetion
in incidence and mortality, the unfavourablc effects and the cost-effectiveness
of different screening polides (age range and interval combinations). To this
end, we used acervical eaueer version of MISCAN, a simulation model that was
designed and programmed to evaluate cancer screening. This cervical eaueer
screening model. had already been tested against screening data sets from
British Columbia (Canada) and from Dutch pilot screeningprojectsin 1976-
1985. The potential impact of new developments in cervical eaueer screening,
such as auto~1ated cytological evaluation and HPV-testing, has been investigated.
The ultimate questions are: should ccrvical caoeer screening be conti.
nued, and what changes should be recommended in order to iinprove its
efficiency?
The relationship between benefits and unfavourable effects was stuclied for
three efficient cervical cancer screening strategies incorporating 5, 10 and 25
smears per woman (Chapter 2). It was concluded that wlien the screening
frequency was increased, the ratio of favourable to unfavourable effects became
worse.