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October 20, 1999, Vol 282, No. 15 >

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Letters | October 20, 1999

Cost-effectiveness of Methods to Enhance Sensitivity of Papanicolaou Testing

Thomas V. Sedlacek, MD
JAMA. 1999;282(15):1419-1420. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009.
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To the Editor: The article by Mr Brown and Dr Garber1 contributes little to our understanding of important issues relating to improved methods of screening for cervical cancer. It relies on fundamentally unsound assumptions.

The Eddy model on which this study was based was designed to study screening intervals, not cost-effectiveness. This flawed model was constructed on an old database, which does not reflect the impact of the human papillomavirus epidemic and did not screen patients younger than 35 years.2 Since cervical cancer has become such a rare disease, measuring changes in life-years saved is not relevant.

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