Cervical screening

Background

Worldwide, cervical cancer is the third most common type of cancer in women, yet the incidence in the U.K. has decreased by more than 40% since the introduction of the NHS Cervical Screening Programme in 1988. Before becoming cancerous, cells in the cervix can show changes often referred to as dyskaryosis or cervical intra-epithelial neoplasia (CIN). If untreated, these abnormal cells can develop into cervical cancer. In the U.K. the majority of women with CIN do not develop the disease due to the early detection and treatment, facilitated by the screening programme.
The conventional Pap smear test is currently being phased out and replaced with the use of liquid-based cytology (LBC). LBC is a new technology which is associated with a reduction in the number of inadequate results from 9% to less than 2%, significantly decreasing the need for repeat tests and hence reducing the strain on cytology services. ScHARR have carried out a systematic review and economic analysis of LBC.
Link: http://www.hta.nhsweb.nhs.uk/fullmono/mon820.pdf

National guidelines have recently been revised for the referral to colposcopy services of patients obtaining a mild result during cervical screening. ScHARR have undertaken some work to estimate the effects of these changes upon colposcopy capacity and cost-effectiveness. A Colposcopy Capacity Model and a Colposcopy Cost-effectiveness Model produced in Excel allow the user to input data regarding local policies and their local population data in order to assess the impact of policy changes, including the mild referral policy, upon the capacity and cost-effectiveness of their clinic.

Models available to Colposcopy Clinics

ScHARR made available a Colposcopy Capacity Model and a Colposcopy Cost-effectiveness Model in Excel which allowed the user to input data regarding local policies and their local population data in order to assess the impact of policy changes, including the mild referral policy, upon the capacity and cost-effectiveness of their clinic.

The Colposcopy Capacity Model has now been updated to include HPV triage and HPV 'test of cure' and is available below.

The Clinical-effectiveness model has now been updated to include HPV triage and HPV 'test of cure and is available below.