Bethwaite J, Rayner T, Bethwaite P
N Z Med J. 1986 Oct 8;99(811):747-51.
The allocation of scarce health resources to cervical screening indicates that an implicit valuation is being placed on the lives that will be saved. From a model which compares the lives saved with the costs of various screening policies, the valuation of life implied by these policies has been calculated. Screening every three years implies a valuation of life of between $86,000 and $191,000 (1984 prices), which is of a similar order of magnitude to valuations placed on life for other policy purposes. Annual screening would only be appropriate if the valuation of life is $420,000 or over. If screening is to take place at all then it should be done at least every five years. Very infrequent screening cannot be justified because the costs of screening still have to be borne, yet the frequency of detection allows a considerable development of invasive lesions between screenings.
将稀缺的卫生资源用于子宫颈癌筛查表明,人们正在对将要挽救的生命进行隐性估值。通过一个将挽救的生命与各种筛查政策的成本进行比较的模型,计算出了这些政策所隐含的生命价值。每三年进行一次筛查意味着生命价值在86,000美元至191,000美元之间(1984年价格),这与为其他政策目的对生命的估值处于相似的数量级。只有当生命价值为420,000美元或更高时,每年进行筛查才是合适的。如果要进行筛查,那么至少应该每五年进行一次。极不频繁的筛查是不合理的,因为筛查成本仍然需要承担,而且检测频率使得在两次筛查之间侵袭性病变会有相当大的发展。