{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T08:05:52Z","timestamp":1753862752879,"version":"3.41.2"},"reference-count":27,"publisher":"Wiley","issue":"19","license":[{"start":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T00:00:00Z","timestamp":1728864000000},"content-version":"vor","delay-in-days":13,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007192","name":"Rijksinstituut voor Volksgezondheid en Milieu","doi-asserted-by":"publisher","award":["4410002642"],"award-info":[{"award-number":["4410002642"]}],"id":[{"id":"10.13039\/501100007192","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Computer\u2010assisted screening (CAS) shows equal performance compared to manual screening, although results are heterogeneous. Furthermore, using CAS may save costs through a potentially increased screening productivity of technicians, therefore also offering a solution for temporary and structural capacity shortage. We evaluated the circumstances under which CAS will be cost\u2010effective compared to manual cytology triage in a primary HPV\u2010based cervical screening programme.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Microsimulation model MISCAN\u2010Cervix was used to evaluate 198 different CAS scenarios with varying probabilities to detect cervical intraepithelial neoplasia grade 1 (CIN1) and CIN3 and cost reductions per test, compared to manual cytology triage. Cost\u2010effectiveness was evaluated by costs per (quality\u2010adjusted) life year ((QA)LY) gained.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>CAS will be cost\u2010effective in all scenarios, except for the following combinations: (1) no cost reduction and an increased probability of detecting CIN1, (2) a cost reduction of \u20ac2 per test and an increased probability of detecting CIN1 from 4% onwards or (3) a cost reduction of \u20ac4 per test and an increased probability of detecting CIN1 from 6% onwards, compared to manual cytology triage. All CAS scenarios with any reduction in the probability of detecting CIN1 (i.e., increased CIN2+ specificity), or a reduction in costs from \u20ac6 per test onwards suggested a more cost\u2010effective strategy compared to manual cytology triage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>As we based our analysis on a realistic range in costs and test performance, the implementation of CAS is likely to be cost\u2010effective. Our results can be used as a guideline to advise when to choose CAS instead of manual cytology triage.<\/jats:p><\/jats:sec>","DOI":"10.1002\/cam4.70299","type":"journal-article","created":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T13:51:07Z","timestamp":1728913867000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost\u2010Effectiveness of Computer\u2010Assisted Cytology in a Primary hrHPV\u2010Based Cervical Cancer Screening Programme"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-6216","authenticated-orcid":false,"given":"Ellen\u00a0M.\u00a0G.","family":"Olthof","sequence":"first","affiliation":[{"name":"Department of Public Health Erasmus MC University Medical Center Rotterdam  Rotterdam The 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