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| |  Automated Pap Smear Screening May Be Cost-Prohibitive CHICAGO, IL -- January 20, 1998 -- A new device that uses computers to analyze Pap smears only slightly increases the accuracy of detecting abnormal results at a cost of 20 to 30 times more than traditional testing methods, according to an article in tomorrow’s issue of The Journal of the American Medical Association (JAMA) Timothy O'Leary, M.D., Ph.D., of the Armed Forces Institute of Pathology in Washington, D.C., and colleagues evaluated the accuracy and cost-effectiveness of an automated device called Papnet, which was recently approved by the United States Food and Drug Administration. Papnet was used to rescreen 5,478 Pap smears, which had previously been identified as normal, from female service members. The researchers determined that using Papnet over manual rescreening methods found only one more abnormal Pap smear for every 913 cases. Papnet also yielded only one more diagnosis of the sexually transmitted disease human papillomavirus (HPV) for every 2,739 cases rescreened. The researchers estimate rescreening with Papnet would cost $33,781 for each abnormal Pap smear identified and $101,343 for each HPV identified, compared to $1,065 and $4,970, respectively, for manual rescreening. Pap smears, tests used to detect abnormal changes in the cells of the cervix, are used to detect cervical cancer and some sexually transmitted diseases. Sample cells are collected during a pelvic examination and are usually sent to a laboratory for examination under a microscope. Papnet and other automated systems aim to reduce the significant number of false-negative results of laboratory manual screening, the authors write. However, given the high costs of using the automated system, the researchers suggest other ways to reduce cervical cancer death, such as implementing more effective screening programs like performing Pap smears on women who do not currently get them. "This statistically valid study of thousands of cases demonstrates a very slight improvement in quality produced by use of this automated device," said George Lundberg, M.D., editor of JAMA. "But such use produced costs greatly in excess of traditional methods. "These results suggest that a prudent health care system would not apply this device for widespread use in our current cost-conscious environment."
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