Cost analysis of PAPNET-assisted vs. conventional pap smear evaluation in primary screening of cervical smears

OBJECTIVE: To assess the difference in casts between PAPNET-assisted and co nventional microscopy of cervical smears when used as a primary screening t ool. STUDY DESIGN: We performed time measurements of the initial screening of sm ears by four cytotechnologists in one laboratory. Time runs measured in 816 conventionally screened smears and in 614 smears with PAPNET-assisted scre ening. Data were collected oil the components of initial screening, clerica l activities and other activities in the total work time of cytotechnologis ts in the routine situation and on resource requirements for both technique s. RESULTS: PAPNET saved an average of 22% on initial screening time per smear . Due to costs of processing and additional equipment, the costs of PAPNET- assisted screening were estimated to be $2.85 (and at least $1.79) higher p er smear than conventional microscopy. The difference in costs is sensitive to the rate of time saving, the possibility of saving on quality control p rocedures and the component of the initial screening time in the total work time of cytotechnologists. CONCLUSION: Although PAPNET is time saving as compared with conventional mi croscopy, the associated reduction in personnel costs is outweighed by the costs of scanning the slides and additional equipment. This con elusion hol ds under a variety of assumptions. Using PAPNET instead of conventional mic roscopy as a primary screening tool will make cervical cancer screening les s cost-effective unless the costs of PAPNET are considerably reduced and it s sensitivity and/or specificity are considerably improved.