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. 1992 Jun;65(6):930–933. doi: 10.1038/bjc.1992.195

Preventive Pap-smears: balancing costs, risks and benefits.

M van Ballegooijen 1, J D Habbema 1, G J van Oortmarssen 1, M A Koopmanschap 1, J T Lubbe 1, H M van Agt 1
PMCID: PMC1977773  PMID: 1616867

Abstract

The pattern of spontaneous screening for cervical cancer by general practitioners and gynaecologists in The Netherlands is compared with an efficient screening policy resulting from a cost-effective study. Spontaneous screening tends to start and stop too early in a woman's life, and leaves too many women overscreened or unprotected. The combination in young age of a low incidence of invasive cancer and a high incidence of regressive lesions explains relative ineffectiveness and harmfulness of present screening practice. When screening would take place between ages 30 and at least 60, with intervals of about 5 years, as many lives could be saved for half the costs and with only 60% of the unnecessary referrals and treatments. Much attention should be paid to the coverage of the target population. Therapeutic follow-up policies for dysplastic lesions should be restrained.

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Selected References

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