A cost-effectiveness analysis of screening strategies for cervical intraepithelial neoplasia.

<bold>Objective: </bold>To assess the costs and usefulness of colposcopy using three screening strategies for cervical intraepithelial neoplasia (CIN).<bold>Materials and Methods: </bold>A decision model compared three screening strategies for CIN: (1) patients were screened annually with a conventional Pap smear, (2) patients were screened annually with a liquid-based cytologic method and reflex human papillomavirus testing for atypical squamous cells of undetermined significance results, and (3) patients were screened biennially with a liquid-based cytologic method and reflex human papillomavirus testing for atypical squamous cells of undetermined significance results.<bold>Results: </bold>Biennial liquid-based screening was the least expensive strategy with a cost of $9.5 million per 100,000 patients. Annual liquid-based screening was the most expensive strategy at $13.7 million. Annual conventional screening had an intermediate cost of $11.6 million. Biennial liquid-based screening referred the fewest patients to colposcopy (11.8%), followed by annual conventional screening and annual liquid-based screening (15.2% and 15.6%, respectively).<bold>Conclusions: </bold>Each of these treatment strategies is reasonable; however, biennial liquid-based screening would reduce medical costs significantly. [ABSTRACT FROM AUTHOR]