THE SHORT-TERM FINANCIAL COSTS OF ABNORMAL PAP SMEARS TO WOMEN AND GOVERNMENT IN AUSTRALIA

Using data collected from a private Canberra colposcopy service, we ex amined the direct costs, to women and government, of the gynaecologica l care of women with cervical cytological abnormalities and determine the potential savings of implementing the Commonwealth recommendations for the clinical care of women with screen-detected abnormalities. We performed a case note audit of 502 women who first attended a gynaeco logist because of an abnormal Pap smear between 1 January 1989 and 30 April 1990. The smear resulting in their referral - their presenting s mear - was categorised as No CIN (showing no evidence of cervical intr aepithelial neoplasia), CIN 1, CIN 2 and CIN 3. The average costs to g overnment (p for trend <0.001) and women (p for trend = 0.006) increas e as the presenting smear increases in severity; the median costs to g overnment (p for trend <0.001) and women (p for trend <0.001) also ros e with increasing cytological severity. Treatment of CIN 1 and No CIN accounted for half the costs incurred by government and women. Althoug h costs increase with increasing severity of cytological abnormality, adherence to new Australian guidelines for the gynaecological care of women with screen-detected cervical abnormalities could result in subs tantial short-term savings to government and women.