The utility and cost-effectiveness of Pap test rescreening.

Although most laboratories practice 10% manual rescreening of negative Pap tests, the cost-effectiveness of this and other rescreening strategies rarely has been evaluated. A decision model was created in which rescreening strategies were compared with nonrescreening strategies in terms of the number of false negative and positive diagnoses, cancers, life expectancy, and cost-effectiveness. The 10% rescreening with a repeat Pap test strategy yielded almost no gain in life expectancy in comparison to an equivalent strategy with no rescreening. A 100% rescreening strategy generally was more cost-effective than a no-rescreening strategy at costs of rescreening varying from $2 to $10 per patient. We conclude that if the rescreening cost is low, 100% rescreening strategies are more cost-effective than nonrescreening strategies.