Table 2.
Selected estimates for screening test accuracy, costs and utilities.
| Screening Adherence (1) | |||
|---|---|---|---|
| <20 | 0.5-0.75 (0.35-1.0) | ||
| 20-29 | 0.5-0.8 (0.35-1.0) | ||
| 30-39 | 0.7-0.9 (0.5-1.0) | ||
| 40-49 | 0.6-0.9 (0.4-1.0) | ||
| 50+ | 0.3-1.0 (0.2-1.0) | ||
| Screening Test Accuracy [8,21]1,2 | |||
| Age <30 | Age 30+ | ||
| Pap sensitivity for CIN 1+ | 0.42 (0.31-0.72) | 0.32 (0.30-0.66) | |
| Pap specificity for <CIN 1 | 0.98 (0.80-0.95) | 0.94 (0.82-0.95) | |
| HPV sensitivity for CIN 1+ | 0.83 (0.68-1.0) | 0.71 (0.65-1.0) | |
| HPV specificity for <CIN 1 | 0.83 (0.80-0.97) | 0.97 (0.94-1.0) | |
| HPV and Pap sensitivity for CIN 1+ | 0.88 (0.72-1.0) | 0.75 (0.69-1.0) | |
| HPV and Pap specificity for <CIN 1 | 0.82 (0.79-0.96) | 0.95 (0.92-1.0) | |
| Costs in Canadian $ (2006)[26-29,31]3 | |||
| Canada and Ontario | Alberta | Newfoundland | |
| Conventional Pap | $28 ($14-$56) | $30 ($15-$59) | $29 ($14-$58) |
| Liquid-based Pap | $32 ($16-64) | $35($17-$70) | $33 ($16-$65) |
| HPV test (hc2) | $53 ($14-$106) | $50 ($14-$100) | $53 ($14-$106) |
| Colposcopy + biopsy | $337 ($168-$673) | $376 ($188-$752) | $412 ($206-$824) |
| LEEP | $965 ($83-$1930) | $1082 ($541-$2164) | $1044 ($522-$2088) |
| Stage I Cancer | $11153 ($5576-$22305) | $12126 ($6063-$24253) | $11898 ($5949-$23797) |
| Stage II - III Cancer | $17644 ($8822-$35288) | $19185 ($9592-$38369) | $18824 ($9412-$37648) |
| Stage IV - Cancer | $24110 ($12055-$48220) | $26215 ($13107-$52430) | $25722 ($21861-$51445) |
| Utilities[32]4 | |||
| False-positive screening test result | -.02 | ||
| Duration | 2 1/2 months[8] | ||
| Stage I Cancer | 0.76 | ||
| Duration | 5 years 5 | ||
| Stage II - IV Cancer | 0.67 | ||
| Duration | 5 years 5 | ||
1 Ranges used for beta distributions for probabilistic sensitivity analyses
2 Estimates of sensitivity assumed to be the same for LBC; specificity estimated to be 0.84[23] of base estimate of specificity for conventional Pap.
3 Ranges used for normal distributions for costs for probabilistic sensitivity analyses
4 Cost per quality-adjusted life-year calculated in sensitivity analyses
5 Women who are alive at the end of 5 years are assumed to enter the cancer survivor state. The utility for a cancer survivor is assumed to be 1.