Tjalma Wiebren A A, Kim Emily, Vandeweyer Katleen
Multidisciplinary Breast Clinic, Unit Gynecologic Oncology, Antwerp University Hospital, University of Antwerp, Belgium.
Roche Molecular Systems, Inc., Pleasanton, CA 94588, USA.
Eur J Obstet Gynecol Reprod Biol. 2017 May;212:171-181. doi: 10.1016/j.ejogrb.2017.01.010. Epub 2017 Jan 5.
Dual stain cytology, or "diagnostic cytology", offers a significant increase in sensitivity compared to cytology, with a slight decrease in specificity. This can reduce additional investigations like colposcopies, biopsies, and follow-up visits. Cervical cancer screening for women between 25 and 65 years of age with diagnostic cytology is estimated to reduce the incidence of cervical cancer by 36% and reduce annual cervical cancer mortalities by 40%. The reduced number of screening visits and the decrease in incidence and mortality will improve quality of life. In this article, a model was created to evaluate the cost-effectiveness of diagnostic cytology for Belgium. In this approach, precancerous cells are more likely to be immediately identified during the first screening visit. This reduces both the number and frequency of follow-up visits required. After two cycles (6 years), the prevalence of CIN and cervical cancer is decreased significantly in the screened population. At a population level, these shifts can reduce the screening budget by 21%, resulting in savings of 5.3 million euro a year in Belgium. Diagnostic cytology benefits all stakeholders involved in cervical cancer screening.
双染细胞学，即“诊断性细胞学”，与传统细胞学相比，敏感性显著提高，但特异性略有下降。这可以减少诸如阴道镜检查、活检和随访等额外检查。据估计，对25至65岁女性进行诊断性细胞学宫颈癌筛查可使宫颈癌发病率降低36%，并使宫颈癌年度死亡率降低40%。筛查次数的减少以及发病率和死亡率的降低将改善生活质量。在本文中，创建了一个模型来评估比利时诊断性细胞学的成本效益。在这种方法中，癌前细胞更有可能在首次筛查时就被立即识别出来。这减少了所需随访的次数和频率。经过两个周期（6年），筛查人群中宫颈上皮内瘤变（CIN）和宫颈癌的患病率显著降低。在人群层面，这些变化可使筛查预算减少21%，在比利时每年节省530万欧元。诊断性细胞学使参与宫颈癌筛查的所有利益相关者都受益。
