The impact of new technologies in cervical cancer screening: Results of the recruitment phase of a large randomised controlled trial from a public health perspective

The decision to introduce liquid‐based cytology (LBC) and HPV as screening tests involves criteria based on resource consumption. We used cross‐sectional data at recruitment from the NTCC trial [ISRCTN81678807] on 28,000 women aged 35–60, randomised to receive a conventional Pap test or LBC plus HPV. We computed the resources employed to detect a CIN2+ with different screening strategies. In order to result in the same overall cost per CIN2+ detected as screening by conventional cytology, the unit cost of LBC used alone should be less than that of a conventional Pap while its unit cost may be up to 20% higher if HPV‐triage for Atypical Squamous Cells of Undetermined Significance is applied together. With the same criterion the unit cost of HPV used alone may be about 20% higher than that of a Pap‐test using a 1 pg/ml cut‐off and over 40% higher using a 10 pg/ml cut‐off. If HPV testing is applied with cytology‐triage, a single HPV test may cost 20–30% more than a conventional Pap to result in the same overall cost per CIN2+ detected. © 2007 Wiley‐Liss, Inc.