Cost and logistics of alternative roll-out options for implementing human papillomavirus testing as a triage in cervical screening: results of the sentinel sites study

Br J Cancer. 2012 Oct 23;107(9):1574-9. doi: 10.1038/bjc.2012.435. Epub 2012 Oct 4.


Background: Previous studies have indicated that human papillomavirus (HPV) testing as a triage for managing equivocal cytology is cost-effective. The aim of this study was to assess the costs of alternative roll-out options.

Methods: Detailed cost estimates were collected from six laboratories where HPV triage had been implemented. Costs were assessed for the two different service delivery models that were implemented; a 'hub and spoke model' of central HPV testing in a microbiology laboratory with separate cytology laboratories, and an 'integrated model' where HPV testing was conducted within the cytology laboratory.

Results: Comparison of alternative delivery models indicated that setting up HPV processing within existing cytology laboratory, i.e., an 'integrated cytology/HPV laboratory' generated savings in staff time amounting to between £2.54 and 4.86 per sample processed. Running full HPV testing batches was also an important consideration. For full batches to be run on a twice weekly basis requires having no more than two laboratories per Strategic Health Authority.

Conclusions: To be cost-efficient, and to meet turn-around times, HPV testing needs to be conducted at integrated cytology/HPV testing centres with sufficient throughput to run full batches of HPV tests.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cervical Intraepithelial Neoplasia / economics
  • Cervical Intraepithelial Neoplasia / virology*
  • Cost-Benefit Analysis
  • Cytological Techniques / economics*
  • Cytological Techniques / methods*
  • Early Detection of Cancer
  • Female
  • Humans
  • Mass Screening / economics
  • Mass Screening / methods
  • Middle Aged
  • Papillomaviridae / isolation & purification
  • Papillomavirus Infections / diagnosis*
  • Papillomavirus Infections / economics*
  • Papillomavirus Infections / virology
  • Surveys and Questionnaires
  • Triage / economics*
  • United Kingdom
  • Uterine Cervical Neoplasms / economics
  • Uterine Cervical Neoplasms / virology*