Preventive Pap-smears: balancing costs, risks and benefits

Br J Cancer. 1992 Jun;65(6):930-3. doi: 10.1038/bjc.1992.195.


The pattern of spontaneous screening for cervical cancer by general practitioners and gynaecologists in The Netherlands is compared with an efficient screening policy resulting from a cost-effective study. Spontaneous screening tends to start and stop too early in a woman's life, and leaves too many women overscreened or unprotected. The combination in young age of a low incidence of invasive cancer and a high incidence of regressive lesions explains relative ineffectiveness and harmfulness of present screening practice. When screening would take place between ages 30 and at least 60, with intervals of about 5 years, as many lives could be saved for half the costs and with only 60% of the unnecessary referrals and treatments. Much attention should be paid to the coverage of the target population. Therapeutic follow-up policies for dysplastic lesions should be restrained.

MeSH terms

  • Age Factors
  • Cost-Benefit Analysis
  • Female
  • Follow-Up Studies
  • Humans
  • Papanicolaou Test*
  • Regression Analysis
  • Risk Factors
  • Uterine Cervical Neoplasms / diagnosis*
  • Vaginal Smears / economics*