{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T18:27:26Z","timestamp":1788200846522,"version":"build-2803163510"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T00:00:00Z","timestamp":1731888000000},"content-version":"unspecified","delay-in-days":322,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int J Technol Assess Health Care"],"published-print":{"date-parts":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:sec id=\"S0266462324000540_sec1\">\n\t    <jats:title>Objectives<\/jats:title>\n\t    <jats:p>To synthesize the results of cost-effectiveness studies of different triage tests in comparison to repeat cytology for women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL) results.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0266462324000540_sec2\" sec-type=\"methods\">\n\t    <jats:title>Methods<\/jats:title>\n\t    <jats:p>Electronic databases (Medline\/PubMed, Lilacs, Embase, The Cochrane Library, Scopus, Web of Science, Scielo, The NHS Economic Evaluation Database, Econlit, and CEA Registry) were searched for cost-effectiveness or cost-utility publications. Per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, two independent reviewers selected eligible publications based on the selection criteria and performed data extraction. Methodological quality was assessed using the Quality of Health Economic Studies tool.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0266462324000540_sec3\" sec-type=\"results\">\n\t    <jats:title>Results<\/jats:title>\n\t    <jats:p>Five cost-effectiveness analyses were included comparing HPV testing, immediate colposcopy, and liquid-based cytology with HPV testing reflex to repeat cytology. The main outcome adopted was cervical intraepithelial neoplasia level 2 or higher (CIN2+) cases detected. In pairwise comparisons, HPV testing was more frequently observed as the most cost-effective strategy. Incremental cost-effectiveness ratios were very sensitive to costs of test kit variation and accuracy estimates with some sensitivity analysis scenarios showing immediate colposcopy more cost-effective than HPV testing depending on the tests\u2019 unitary costs and effectiveness.<\/jats:p>\n\t  <\/jats:sec>\n\t  <jats:sec id=\"S0266462324000540_sec4\" sec-type=\"conclusions\">\n\t    <jats:title>Conclusions<\/jats:title>\n\t    <jats:p>This systematic review of economic evidence corroborates clinical evidence showing cytology is the least effective, although less costly, triage strategy. Cytology-based triage programs need to be updated to offer timely treatment to women diagnosed with ASC-US\/LSIL and better resource allocation.<\/jats:p>\n\t  <\/jats:sec>","DOI":"10.1017\/s0266462324000540","type":"journal-article","created":{"date-parts":[[2024,11,18]],"date-time":"2024-11-18T08:23:00Z","timestamp":1731918180000},"source":"Crossref","is-referenced-by-count":2,"title":["Systematic review of economic evaluations of triage tests for women with atypical squamous cells of undetermined significance (ASC-US) or low-grade squamous intraepithelial lesions (LSIL)"],"prefix":"10.1017","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3086-1210","authenticated-orcid":false,"given":"Isandra","family":"Meirelles","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7568-5014","authenticated-orcid":false,"given":"M\u00e1rcia","family":"Pinto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6610-9357","authenticated-orcid":false,"given":"Leticia","family":"Barros","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7510-0485","authenticated-orcid":false,"given":"Fabio","family":"Russomano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,11,18]]},"reference":[{"key":"S0266462324000540_r42","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)62218-7"},{"key":"S0266462324000540_r3","unstructured":"3. 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Minist\u00e9rio de Sa\u00fade. Diretrizes metodol\u00f3gicas\u00a0: Diretriz de Avalia\u00e7\u00e3o Econ\u00f4mica \/ Minist\u00e9rio da Sa\u00fade, Secretaria de Ci\u00eancia, Tecnologia e Insumos Estrat\u00e9gicos, Departamento de Ci\u00eancia e Tecnologia [Internet]. 2014 [citado 22 de setembro de 2020]. Dispon\u00edvel em: https:\/\/rebrats.saude.gov.br\/diretrizes-metodologicas"},{"key":"S0266462324000540_r11","unstructured":"11. Brasil, Minist\u00e9rio da Sa\u00fade. SISCAN - Cito do colo - Por local de resid\u00eancia - Brasil [Internet]. [citado 25 de janeiro de 2023]. Dispon\u00edvel em: http:\/\/tabnet.datasus.gov.br\/cgi\/dhdat.exe?SISCAN\/cito_colo_residba.def"},{"key":"S0266462324000540_r19","doi-asserted-by":"publisher","DOI":"10.1007\/s11739-010-0420-7"},{"key":"S0266462324000540_r10","unstructured":"10. World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention [Internet]. 2021. 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