{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T04:06:19Z","timestamp":1785297979144,"version":"3.55.0"},"reference-count":20,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"unspecified","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Hologic Diagnostics","award":["N\/A"],"award-info":[{"award-number":["N\/A"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,11]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>We aimed to estimate the time required to review and report cervical cytology slides within a Human Papillomavirus (HPV)-primary cervical cancer screening programme, where cytology is used for triage following a positive HPV test, comparing Artificial Intelligence (AI)-assisted digital cytology (Genius) with manual microscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A decision-tree model of the flow of slides through the National Health Service (NHS) England cervical screening cytology laboratory workflow, parameterised using published evidence and expert input.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Cytology laboratories within the NHS Cervical Screening Programme in England and Scotland.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Screening and reporting 479,125 cytology slides annually in England was estimated to require 31,842 staff hours with AI-assisted digital cytology versus 103,151\u2009hours with manual microscopy. The mean time per slide review and reporting was 4.0 vs 12.9\u2009minutes, respectively, corresponding to a potential 69% increase in overall productivity.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AI-assisted digital cytology can support more resilient cervical screening programmes in the UK and other countries by reducing staff time required for slide review and reporting. These findings may inform policymakers considering strategies to mitigate workforce shortages.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-113298","type":"journal-article","created":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:40:11Z","timestamp":1785296411000},"page":"e113298","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Improving laboratory workforce efficiency using AI-assisted digital cytology within an HPV-based cervical screening programme: A model-based evaluation for the NHS Cervical Screening Programmes"],"prefix":"10.1136","volume":"16","author":[{"given":"Allan","family":"Wilson","sequence":"first","affiliation":[{"name":"Pathology Department, Monklands Hospital, Lanarkshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alison","family":"Cropper","sequence":"additional","affiliation":[{"name":"Cytology Department, University Hospitals of Derby and Burton NHS Foundation Trust, Royal Derby Hospital, Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yixuan","family":"Ma","sequence":"additional","affiliation":[{"name":"Aquarius Population Health Limited, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4222-9394","authenticated-orcid":false,"given":"Elisabeth J","family":"Adams","sequence":"additional","affiliation":[{"name":"Aquarius Population Health Limited, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sue","family":"Mehew","sequence":"additional","affiliation":[{"name":"Pathology Department, Royal Infirmary of Edinburgh, NHS Lothian, Edinburgh, UK"},{"name":"Cytology Department, Monklands Hospital, NHS Lanarkshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Morgan","sequence":"additional","affiliation":[{"name":"Health Services Laboratories, London, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichole","family":"Villeneuve","sequence":"additional","affiliation":[{"name":"Cytology Department, North Bristol NHS Trust, Bristol, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caron","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Cytology Department, University Hospitals of Derby and Burton NHS Foundation Trust, Royal Derby Hospital, Derby, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026072820400568000_16.7.e113298.1","unstructured":"Cervical cancer. 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NHS.UK. 2023. Available: https:\/\/www.nhs.uk\/tests-and-treatments\/cervical-screening\/when-youll-be-invited\/ [Accessed 29 Apr 2026]."},{"key":"2026072820400568000_16.7.e113298.6","unstructured":"England NHS . NHS England\u202f\u00bb NHS rolls out more personalised cervical screening for millions. 2025. Available: https:\/\/www.england.nhs.uk\/2025\/06\/nhs-rolls-out-more-personalised-cervical-screening-for-millions\/ [Accessed 29 Apr 2026]."},{"key":"2026072820400568000_16.7.e113298.7","unstructured":"NHS England . Cervical Screening Programme, England - 2023-2024 [NS]. 2024. Available: https:\/\/digital.nhs.uk\/data-and-information\/publications\/statistical\/cervical-screening-annual\/england-2023-24 [Accessed 5 May 2026]."},{"key":"2026072820400568000_16.7.e113298.8","doi-asserted-by":"crossref","first-page":"6734","DOI":"10.1016\/j.vaccine.2023.10.002","article-title":"The impact of over ten years of HPV vaccination in England: Surveillance of type-specific HPV in young sexually active females","volume":"41","author":"Checchi","year":"2023","journal-title":"Vaccine"},{"key":"2026072820400568000_16.7.e113298.9","doi-asserted-by":"crossref","first-page":"278","DOI":"10.1038\/s41416-022-01791-w","article-title":"The impact of catch-up bivalent human papillomavirus vaccination on cervical screening outcomes: an observational study from the English HPV primary screening pilot","volume":"127","author":"Rebolj","year":"2022","journal-title":"Br J Cancer"},{"key":"2026072820400568000_16.7.e113298.10","unstructured":"British Association for Cytopathology. Cervical cytology workforce survey 2024. 2025. Available: https:\/\/www.britishcytology.org.uk\/uploads\/files\/BAC-workforce-survey-BAC-ASM-2024-CROPPER.pdf"},{"key":"2026072820400568000_16.7.e113298.11","unstructured":"Genius Digital Diagnostics System | Hologic. 2021. Available: https:\/\/www.hologic.com\/package-inserts\/diagnostic-products\/genius-digital-diagnostics-system [Accessed 5 May 2026]."},{"key":"2026072820400568000_16.7.e113298.12","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1002\/cncy.22695","article-title":"Comparison of the Hologic Genius Digital Diagnostics System with the ThinPrep Imaging System-A retrospective assessment","volume":"131","author":"Ikenberg","year":"2023","journal-title":"Cancer Cytopathol"},{"key":"2026072820400568000_16.7.e113298.13","unstructured":"NHS cancer screening programmes a guide for laboratories participating in the NHS Cervical Screening Programme. 2003. Available: https:\/\/assets.publishing.service.gov.uk\/media\/5a7f82ad40f0b62305b87959\/nhscsp14.pdf"},{"key":"2026072820400568000_16.7.e113298.14","unstructured":"British association for cytopathology. recommended code of practice for cytology laboratories participating in the UK cervical screening programme. 2022. Available: https:\/\/www.britishcytology.org.uk\/uploads\/files\/BAC-recommended-code-of-practice-for-cytology-laboratories.pdf"},{"key":"2026072820400568000_16.7.e113298.15","doi-asserted-by":"crossref","unstructured":"Cantley RL , Jing X , Smola B , et al . Validation of AI-assisted ThinPrep\u00ae Pap test screening using the GeniusTM Digital Diagnostics System. J Pathol Inform 2024;15. doi:10.1016\/j.jpi.2024.100391","DOI":"10.1016\/j.jpi.2024.100391"},{"key":"2026072820400568000_16.7.e113298.16","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpi.2025.100532","article-title":"Technical considerations during validation of the Genius\u00ae Digital Diagnostic System","volume":"20","author":"Harinath","year":"2026","journal-title":"J Pathol Inform"},{"key":"2026072820400568000_16.7.e113298.17","unstructured":"Cervical screening standards valid for data collected from 1 april 2020. GOV.UK; 2018. Available: https:\/\/www.gov.uk\/government\/publications\/cervical-screening-programme-standards\/cervical-screening-programme-standards-valid-for-data-collected-from-1-april-2018 [Accessed 5 May 2026]."},{"key":"2026072820400568000_16.7.e113298.18","unstructured":"Martinelli C . UK NSC recommends HPV self-sampling option for under-screened women in cervical screening programme. 2025. Available: https:\/\/nationalscreening.blog.gov.uk\/2025\/06\/24\/uk-nsc-recommends-hpv-self-sampling-option-for-under-screened-women-in-cervical-screening-programme\/ [Accessed 5 May 2026]."},{"key":"2026072820400568000_16.7.e113298.19","unstructured":"Institute of Biomedical Science . Digital cytology - A transformative solution for cervical screening in the UK. 2024. Available: https:\/\/www.ibms.org\/resource\/digital-cytology-a-transformative-solution-for-cervical-screening-in-the-uk.html [Accessed 5 May 2026]."},{"key":"2026072820400568000_16.7.e113298.20","unstructured":"Jones KC , Weatherly H , Birch S , et al . Unit cost of health and social care 2024 manual. 2025. Available: https:\/\/doi.org\/10.22024\/UniKent\/01.02.109563"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2025-113298","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T03:40:13Z","timestamp":1785296413000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2025-113298"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":20,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2026,7,28]]},"published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1136\/bmjopen-2025-113298"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2025-113298","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]}}}