{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T23:04:19Z","timestamp":1788908659474,"version":"build-2803163510"},"reference-count":34,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,4,24]],"date-time":"2024-04-24T00:00:00Z","timestamp":1713916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100009128","name":"Research for Patient Benefit Programme","doi-asserted-by":"publisher","award":["PB\u2010PG\u20100816\u201020004"],"award-info":[{"award-number":["PB\u2010PG\u20100816\u201020004"]}],"id":[{"id":"10.13039\/501100009128","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100002341","name":"Academy of Finland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100002341","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000289","name":"Cancer Research UK","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000289","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001711","name":"Schweizerischer Nationalfonds zur F\u00f6rderung der Wissenschaftlichen Forschung","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001711","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To compare the cost\u2010effectiveness of different treatments for cervical intraepithelial neoplasia (CIN).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A cost\u2010effectiveness analysis based on data available in the literature and expert opinion.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population<\/jats:title>\n                    <jats:p>Women treated for CIN.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We developed a decision\u2010analytic model to simulate the clinical course of 1000 women who received local treatment for CIN and were followed up for 10\u2009years after treatment. In the model we considered surgical complications as well as oncological and reproductive outcomes over the 10\u2010year period. The costs calculated were those incurred by the National Health Service (NHS) of England.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Cost per one CIN2+ recurrence averted (oncological outcome); cost per one preterm birth averted (reproductive outcome); overall cost per one adverse oncological or reproductive outcome averted.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>For young women of reproductive age, large loop excision of the transformation zone (LLETZ) was the most cost\u2010effective treatment overall at all willingness\u2010to\u2010pay thresholds. For postmenopausal women, LLETZ remained the most cost\u2010effective treatment up to a threshold of \u00a331,500, but laser conisation became the most cost\u2010effective treatment above that threshold.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>LLETZ is the most cost\u2010effective treatment for both younger and older women. However, for older women, more radical excision with laser conisation could also be considered if the NHS is willing to spend more than \u00a331,500 to avert one CIN2+ recurrence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17829","type":"journal-article","created":{"date-parts":[[2024,4,25]],"date-time":"2024-04-25T00:14:00Z","timestamp":1714004040000},"page":"1411-1419","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Treatment methods for cervical intraepithelial neoplasia in England: A cost\u2010effectiveness analysis"],"prefix":"10.1111","volume":"131","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8816-4389","authenticated-orcid":false,"given":"Michela","family":"Tinelli","sequence":"first","affiliation":[{"name":"Department of Health Policy The London School of Economics and Political Science  London UK"},{"name":"Care Policy Evaluation Centre The London School of Economics and Political Science  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Athanasiou","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction \u2013 Surgery and Cancer, Institute of Reproductive and Developmental Biology (IRDB) Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Areti Angeliki","family":"Veroniki","sequence":"additional","affiliation":[{"name":"Institute for Health Policy, Management and Evaluation University of Toronto  Toronto Ontario Canada"},{"name":"Knowledge Translation Program, Li Ka Shing Knowledge Institute St. Michael's Hospital, Unity Health Toronto  Toronto Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Orestis","family":"Efthimiou","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine (ISPM) University of Bern  Bern Switzerland"},{"name":"Institute of Primary Health Care (BIHAM) University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilkka","family":"Kalliala","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction \u2013 Surgery and Cancer, Institute of Reproductive and Developmental Biology (IRDB) Imperial College London  London UK"},{"name":"Department of Obstetrics and Gynaecology University of Helsinki and Helsinki University Hospital  Helsinki Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Bowden","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction \u2013 Surgery and Cancer, Institute of Reproductive and Developmental Biology (IRDB) Imperial College London  London UK"},{"name":"Department of Obstetrics and Gynaecology Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Paraskevaidi","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction \u2013 Surgery and Cancer, Institute of Reproductive and Developmental Biology (IRDB) Imperial College London  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deirdre","family":"Lyons","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0520-0066","authenticated-orcid":false,"given":"Pierre","family":"Martin\u2010Hirsch","sequence":"additional","affiliation":[{"name":"Department of Gynaecologic Oncology Lancashire Teaching Hospitals  Preston UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6253-4919","authenticated-orcid":false,"given":"Phillip","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction \u2013 Surgery and Cancer, Institute of Reproductive and Developmental Biology (IRDB) Imperial College London  London UK"},{"name":"Department of Obstetrics and Gynaecology Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evangelos","family":"Paraskevaidis","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynaecology Imperial College Healthcare NHS Trust  London UK"},{"name":"Department of Obstetrics and Gynaecology University of Ioannina and University Hospital of Ioannina  Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgia","family":"Salanti","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine (ISPM) University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7165-0735","authenticated-orcid":false,"given":"Maria","family":"Kyrgiou","sequence":"additional","affiliation":[{"name":"Department of Metabolism, Digestion and Reproduction \u2013 Surgery and Cancer, Institute of Reproductive and Developmental Biology (IRDB) Imperial College London  London UK"},{"name":"Department of Obstetrics and Gynaecology Imperial College Healthcare NHS Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huseyin","family":"Naci","sequence":"additional","affiliation":[{"name":"Department of Health Policy The London School of Economics and Political Science  London 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