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Berman - Figure 23 - Impact on Cost-Effectiveness

According to the 2012 Screening Guidelines, annual screening is excessive.  In response, women may ask, “Is this just a money saving reason?  I am little sceptical.  I’ve always had a Pap every year.”  We need to emphasize that the change in guidelines is meant to:

  • Find disease that is significant.

  • Lower harm by not finding excessive amounts of low-grade disease: 
    -  that will be transient or where changes will go away on their own.
    -  where intervening earlier will not make a difference in lives saved.  

The implications: Fewer Pap and HPV tests as we do less frequent screening, and fewer colposcopies, biopsies, and treatments, although there is a percentage of women who will remain Pap-negative/HPV positive who will require colposcopy.

Complete references for all slides

References

[94] Saslow D, Solomon D, et al “American Cancer Society, American Society for Colposcopy and Cervical Pathology, and American Society for Clinical Pathology Screening Guidelines for the Prevention and Early Detection of Cervical Cancer, Journal of Lower Genital Tract Disease, 2012;6;(3):175-204.

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