{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T14:28:19Z","timestamp":1789914499299,"version":"4.0.1"},"reference-count":30,"publisher":"BMJ","issue":"10","funder":[{"DOI":"10.13039\/501100006364","name":"Institut National Du Cancer","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006364","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,8,21]]},"published-print":{"date-parts":[[2017,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>According to the third cancer plan, organised screening (OS) of cervical cancer (CC) among women aged 25\u201365 years should be implemented in France in the forthcoming years. The most efficient way to implement OS in the French healthcare system is yet to be determined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A microsimulation model was developed adopting a collective \u2018all payers\u2019 perspective. A closed cohort of women eligible for CC screening and representative in terms of age and participation in individual screening (IndScr) by annual Papanicolaou (Pap) testing every 3 years was modelled on a lifetime horizon. Different OS strategies, additive to IndScr with a 61.9% participation rate based on mailed invitations to non-participant women to perform OS were assessed. Similar modalities were applied to OS and IndScr participants. Strategies implied different screening tests (Papanicolaou (Pap) test, human papillomavirus (HPV) test and p16\/Ki67 double staining) and OS periodicity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Compared with IndScr only, all OS strategies were associated with decreased cancer incidence\/mortality (from 14.2%\/13.5% to 22.9%\/25.8%). Most strategies generated extra costs ranging from \u20ac37.9 to \u20ac1607 per eligible woman. HPV testing every 10 and 5 years were cost saving. HPV tests every 10 and 5 years were the most efficient strategies, generating more survival at lower costs than Pap-based strategies. Compared to IndScr only, an HPV test every 10 years was cost saving. The most effective strategies were p16\/Ki67 as primary or HPV positive confirmation tests, with respective incremental cost-effectiveness ratios of \u20ac6 541 250 and \u20ac101 391 per life year. Pap-based strategies generated intermediary results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OS strategies based on the HPV test appear highly efficient. However, our results rely on the assumption that women and practitioners comply with the recommended OS periodicities (3, 5, 10 years). Implementing these OS modalities will require major adaptations to the current CC screening organisation. Pap test-based strategies might be simpler to setup while preparing an appropriate implementation of more efficient OS screening modalities.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2016-014626","type":"journal-article","created":{"date-parts":[[2017,10,7]],"date-time":"2017-10-07T20:10:20Z","timestamp":1507407020000},"page":"e014626","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Organised screening for cervical cancer in France: a cost-effectiveness assessment"],"prefix":"10.1136","volume":"7","author":[{"given":"St\u00e9phanie","family":"Barr\u00e9","sequence":"first","affiliation":[{"name":"Screening Department, French National Cancer Institute (INCa), Boulogne-Billancourt, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8728-9043","authenticated-orcid":false,"given":"Marc","family":"Massetti","sequence":"additional","affiliation":[{"name":"Modeling & Simulation, Public Health Expertise, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henri","family":"Leleu","sequence":"additional","affiliation":[{"name":"Modeling & Simulation, Public Health Expertise, Paris, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"De Bels","sequence":"additional","affiliation":[{"name":"Screening Department, French National Cancer Institute (INCa), Boulogne-Billancourt, \u00cele-de-France, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2017,10,6]]},"reference":[{"key":"2025121300013869000_7.10.e014626.1","unstructured":"Sant\u00e9 HAde . \u00c9tat des lieux et recommandations pour le d\u00e9pistage du cancer du col de l\u2019ut\u00e9rus en France. 2010. http:\/\/www.has-sante.fr\/portail\/jcms\/c_1009772\/fr\/etat-des-lieux-et-recommandations-pour-le-depistage-du-cancer-du-col-de-l-uterus-en-France"},{"key":"2025121300013869000_7.10.e014626.2","unstructured":"Monnereau A , Remontet L M , et al . 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