Optimal screening and management strategies for cervical cancer

The overall goal of health economics is to maximise the health gain achieved by health services within available funding. The application to health economics to cervical screening has the particular goal of finding which screening tests will prevent the most disease at an acceptable cost to the health system. The cost-effectiveness of cervical screening depends in part on the interval between screens. If the interval is very short, such as one or two years then screening may impose high costs with little or no benefit over longer screening intervals. Cervical screening at intervals of three to five years as employed in Ireland is thought to be highly cost-effective. Recent developments in screening technology mean that more advanced tests are now available to detect early stages of cervical disease. These new tests include tests for the DNA and RNA of the human papillomavirus. The health economics research in CERVIVA II is to find which new testing technologies will further enhance the cost-effectiveness of Irish cervical screening services. This involves considering the trade-offs of the likely benefits of new tests that are better able to detect disease against the possible costs of false positives and the costs of the testing technologies themselves.