{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T15:09:49Z","timestamp":1776784189208,"version":"3.51.2"},"reference-count":25,"publisher":"Federacion Colombiana de Obstetricia y Ginecologia","issue":"1","license":[{"start":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T00:00:00Z","timestamp":1776470400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0"}],"funder":[{"DOI":"10.13039\/100004337","name":"Roche","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004337","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["revista.fecolsog.org"],"crossmark-restriction":false},"short-container-title":["Rev. colomb. obstet. ginecol."],"abstract":"<jats:p>Objetivos: evaluar la costo-efectividad de incorporar la prueba de doble tinci\u00f3n p16\/Ki-67 en los esquemas de tamizaje para c\u00e1ncer de cuello uterino en Colombia, comparada con la ruta diagn\u00f3stica est\u00e1ndar.\nMateriales y m\u00e9todos: se desarroll\u00f3 un modelo de \u00e1rbol de decisiones desde la perspectiva del prestador, utilizando datos del mundo real y evidencia cient\u00edfica. El desenlace principal fue el n\u00famero de procedimientos invasivos evitados. Se realizaron an\u00e1lisis determin\u00edsticos y probabil\u00edsticos para explorar la incertidumbre.\nResultados: la inclusi\u00f3n de la prueba de doble tinci\u00f3n p16\/Ki-67 result\u00f3 ser una estrategia dominante, al reducir significativamente colposcopias y biopsias innecesarias, y generar ahorros sanitarios (-$80 millones COP en mujeres de 25 a 29 a\u00f1os y -$54 millones COP en mujeres de 30 a 65 a\u00f1os). El an\u00e1lisis de sensibilidad confirm\u00f3 la robustez del modelo.\nConclusiones: la evaluaci\u00f3n de costo-efectividad realizada sugiere la conveniencia de incorporar la prueba de doble tinci\u00f3n p16\/Ki-67 en los protocolos de tamizaje para c\u00e1ncer de cuello uterino ya que esta optimiza la detecci\u00f3n temprana de lesiones precancerosas y mejora la asignaci\u00f3n de recursos. Se requieren estudios que eval\u00faen el desempe\u00f1o de las pruebas de tamizaci\u00f3n en el contexto local y que incorporen desenlaces de morbimortalidad, con el fin de estimar resultados cl\u00ednicos mayores en un horizonte temporal m\u00e1s amplio.<\/jats:p>","DOI":"10.18597\/rcog.4510","type":"journal-article","created":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T13:28:44Z","timestamp":1776778124000},"update-policy":"https:\/\/doi.org\/10.18597\/crossmark","source":"Crossref","is-referenced-by-count":0,"title":["Costo-efectividad de la inclusi\u00f3n de la doble tinci\u00f3n p16\/ Ki-67 en detecci\u00f3n de lesiones cervicales en Colombia, 2024","Cost-effectiveness of Including p16\/Ki-67 Dual Staining in the Detection of Cervical Lesions in Colombia, 2024"],"prefix":"10.18597","volume":"77","author":[{"given":"Andr\u00e9s","family":"\u00c1lvarez","sequence":"first","affiliation":[{"name":"Viva 1A. Medell\u00edn, Colombia."},{"name":"Viva 1A. Medell\u00edn, Colombia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sim\u00f3n","family":"D\u00edaz","sequence":"additional","affiliation":[{"name":"Viva 1A. Medell\u00edn, Colombia."},{"name":"Viva 1A. Medell\u00edn"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2358-0752","authenticated-orcid":false,"given":"Rafael Alberto","family":"Ni\u00f1o","sequence":"additional","affiliation":[{"name":"Invalue Health Solutions S.A.S. Bogot\u00e1, Colombia."},{"name":"Invalue Health Solutions S.A.S. Bogot\u00e1, Colombia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3488-1570","authenticated-orcid":false,"given":"Yudely Asmith","family":"Medina","sequence":"additional","affiliation":[{"name":"Invalue Health Solutions S.A.S. Bogot\u00e1, Colombia"},{"name":"Invalue Health Solutions S.A.S. Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Chac\u00f3n","sequence":"additional","affiliation":[{"name":"Invalue Health Solutions S.A.S. Bogot\u00e1, Colombia"},{"name":"Invalue Health Solutions S.A.S. Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Franco","sequence":"additional","affiliation":[{"name":"Invalue Health Solutions S.A.S. Bogot\u00e1, Colombia"},{"name":"Invalue Health Solutions S.A.S. Bogot\u00e1, Colombia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"7913","published-online":{"date-parts":[[2026,4,18]]},"reference":[{"key":"106654","doi-asserted-by":"crossref","unstructured":"Arrivillaga M, Malfi-Ruiz D, Medina M. Atenci\u00f3n en salud de mujeres con lesiones precursoras de c\u00e1ncer de cuello uterino: evidencia cualitativa de la fragmentaci\u00f3n del sistema de salud en Colombia. Gerencia y Pol\u00edticas de Salud. 2019;18(37):1-20. https:\/\/doi.org\/10.11144\/Javeriana.rgps18-37.asml","DOI":"10.11144\/Javeriana.rgps18-37.asml"},{"key":"106655","unstructured":"Global Cancer Observatory. Cancer tomorrow [Internet]. Disponible en: https:\/\/gco.iarc.fr\/en"},{"key":"106656","doi-asserted-by":"crossref","unstructured":"Fontham E, Wolf A, Church T, Etzioni R, Flowers C, Herzig A, et al. Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society. CA Cancer J Clin. 2020;70(5):321-46. https:\/\/doi.org\/10.3322\/caac.21628","DOI":"10.3322\/caac.21628"},{"key":"106657","doi-asserted-by":"crossref","unstructured":"Moscicki A, Shiboski S, Hills N, Powell K, Jay N, Hanson E, et al. Regression of low-grade squamous intra-epithelial lesions in young women. Lancet. 2004;364(9446):1678-83. https:\/\/doi.org\/10.1016\/S0140-6736(04)17354-6","DOI":"10.1016\/S0140-6736(04)17354-6"},{"key":"106658","doi-asserted-by":"crossref","unstructured":"Loopik D, Bentley H, Eijgenraam M, Inthout J, Bekkers R, Bentley J. The natural history of cervical intraepithelial neoplasia grades 1, 2, and 3: A systematic review and meta-analysis. J Low Genit Tract Dis. 2021;25(3):221-31. https:\/\/doi.org\/10.1097\/LGT.0000000000000604","DOI":"10.1097\/LGT.0000000000000604"},{"key":"106659","unstructured":"World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. 2nd ed. [Internet]. Geneva: World Health Organization; 2021. Disponible en: https:\/\/www.who.int\/publications\/i\/item\/9789240030824"},{"key":"106660","unstructured":"Gu\u00edas Cl\u00ednicas AUGE. C\u00e1ncer C\u00e9rvico Uterino [Internet]. 2015. Disponible en: https:\/\/icmer.org\/wp-content\/uploads\/2019\/Infecciones_de_transmisi %C3 %B3n_sexual\/Gu %C3 %ADas-cl %C3 %ADnicas-c %C3 %A1ncer-cervicouterino-MINSAL-2015.pdf"},{"key":"106661","unstructured":"OPS. Incorporaci\u00f3n de la prueba del virus del papiloma humano en programas de prevenci\u00f3n de c\u00e1ncer cervicouterino. Manual para gerentes de programas de salud. [Internet]. Washington: OPS; 2016 . p. 29-31. Disponible en: https:\/\/iris.paho.org\/handle\/10665.2\/31223"},{"key":"106662","doi-asserted-by":"crossref","unstructured":"Chen C, Yang Z, Li Z, Li L. Accuracy of several cervical screening strategies for early detection of cervical cancer: A meta-analysis [Internet]. Int J Gynecol Cancer. 2012;22(6):908-21. Disponible en: https:\/\/pubmed.ncbi.nlm.nih.gov\/22672987\/","DOI":"10.1097\/IGC.0b013e318256e5e4"},{"key":"106663","doi-asserted-by":"crossref","unstructured":"Cuzick J, Cadman L, Mesher D, Austin J, Ashdown-Barr L, Ho L, et al. Comparing the performance of six human papillomavirus tests in a screening population. Br J Cancer. 2013;108(4):908. https:\/\/doi.org\/10.1038\/bjc.2013.22","DOI":"10.1038\/bjc.2013.22"},{"key":"106664","doi-asserted-by":"crossref","unstructured":"Ram\u00edrez A, Valls J, Baena A, Rojas F, Ram\u00edrez K, \u00c1lvarez R, et al. Performance of cervical cytology and HPV testing for primary cervical cancer screening in Latin America: An analysis within the ESTAMPA study. The Lancet Regional Health - Americas. 2023;26. https:\/\/doi.org\/10.1016\/j.lana.2023.100593","DOI":"10.1016\/j.lana.2023.100593"},{"key":"106665","unstructured":"Sispro. Ruta Integral de Atenci\u00f3n en Salud, c\u00e1ncer de cuello uterino [Internet]. Disponible en: https:\/\/www.sispro.gov.co\/observatorios\/oncancer\/Paginas\/ruta_integral_cuellouterino.aspx"},{"key":"106666","doi-asserted-by":"crossref","unstructured":"Edgerton N, Cohen C, Siddiqui M . Evaluation of CINtec PLUS\u00ae testing as an adjunctive test in ASC-US diagnosed SurePath\u00ae preparations. Diagn Cytopathol. 2013;41(1):35-40. https:\/\/doi.org\/10.1002\/dc.21757","DOI":"10.1002\/dc.21757"},{"key":"106667","doi-asserted-by":"crossref","unstructured":"El-Zein M, Gotlieb W, Gilbert L, Hemmings R, Behr M , Franco E . Dual staining for p16\/Ki-67 to detect high-grade cervical lesions: Results from the Screening Triage Ascertaining Intraepithelial Neoplasia by Immunostain Testing study. Int J Cancer. 2021;148(2):492-501. https:\/\/doi.org\/10.1002\/ijc.33250","DOI":"10.1002\/ijc.33250"},{"key":"106668","doi-asserted-by":"crossref","unstructured":"Kloboves V, Jerman T, Nolde N, Rep\u0161e A, Jezer\u0161ek S, Pohar \u017d, et al. Interobserver variability and accuracy of p16\/Ki-67 dual immunocytochemical staining on conventional cervical smears. Diagnos Pathol. 2019;14(1). https:\/\/doi.org\/10.1186\/s13000-019-0821-5","DOI":"10.1186\/s13000-019-0821-5"},{"key":"106669","doi-asserted-by":"crossref","unstructured":"Hu Y, Hong Z, Gu L, Xie L, Yang B, Dai H, et al. Evaluation of p16\/Ki-67 dual-stained cytology in triaging HPV-positive women during cervical cancer screening. Cancer Epidemiol Biomarkers Prev. 2020;29(6):1246-52. https:\/\/doi.org\/10.1158\/1055-9965.EPI-19-1180","DOI":"10.1158\/1055-9965.EPI-19-1180"},{"key":"106670","doi-asserted-by":"crossref","unstructured":"Wright T, Stoler M, Ranger-Moore J, Fang Q, Volkir P, Safaeian M, et al. Clinical validation of p16\/Ki\u201067 dual\u2010stained cytology triage of HPV\u2010positive women: Results from the IMPACT trial. Int J Cancer. 2021;150(3):461. https:\/\/doi.org\/10.1002\/ijc.33812","DOI":"10.1002\/ijc.33812"},{"key":"106671","unstructured":"Instituto de Evaluaci\u00f3n Tecnol\u00f3gica en Salud (IETS). Manual para la elaboraci\u00f3n de evaluaciones econ\u00f3micas en salud [Internet]. Bogot\u00e1 D.C.: IETS; 2014. Disponible en: https:\/\/www.iets.org.co\/Archivos\/64\/Manual_evaluacion_economica.pdf"},{"key":"106672","unstructured":"Ministerio de Salud y Protecci\u00f3n Social. Gu\u00eda de Pr\u00e1ctica Cl\u00ednica para la detecci\u00f3n y manejo de lesiones precancerosas de cuello uterino [Internet]. Bogot\u00e1: Minsalud; 2014. p. 1-9. Disponible en: https:\/\/www.minsalud.gov.co\/sites\/rid\/Lists\/BibliotecaDigital\/RIDE\/DE\/CA\/gpc-lesiones-precancerosas-cuello-uterino-completa.pdf"},{"key":"106673","doi-asserted-by":"crossref","unstructured":"Brennan A, Chick S, Davies R. A taxonomy of model structures for economic evaluation of health technologies. Health Econ. 2006;15(12):1295-310. https:\/\/doi.org\/10.1002\/hec.1148","DOI":"10.1002\/hec.1148"},{"key":"106674","doi-asserted-by":"crossref","unstructured":"Termrungruanglert W, Khemapech N, Tantitamit T, Havanond P. Cost effectiveness analysis of HPV primary screening and dual stain cytology triage compared with cervical cytology. J Gynecol Oncol. 2019;30(2). https:\/\/doi.org\/10.3802\/jgo.2019.30.e17","DOI":"10.3802\/jgo.2019.30.e17"},{"key":"106675","doi-asserted-by":"crossref","unstructured":"Am\u00e9zquita M, Silva G, Restrepo D, Ibata L, Ni\u00f1o R, Bustacara M, et al. Budget impact analysis of primary screening with the HPV test and genotyping against conventional cytology in Colombia. Biom\u00e9dica . 2022;42(2):290. https:\/\/doi.org\/10.7705\/biomedica.6016","DOI":"10.7705\/biomedica.6016"},{"key":"106676","doi-asserted-by":"crossref","unstructured":"Harper D, Anderson R, Baker E, Yu T. Cost-effectiveness of p16\/Ki-67 dual-stained cytology reflex following co-testing with hrHPV genotyping for cervical cancer screening. Cancer Prev Res . 2023 ;16(7):393 -404. https:\/\/doi.org\/10.1158\/1940-6207.CAPR-22-0455","DOI":"10.1158\/1940-6207.CAPR-22-0455"},{"key":"106677","doi-asserted-by":"crossref","unstructured":"Heinonen A, Tapper A, Leminen A, Sintonen H, Roine R. Health-related quality of life and perception of anxiety in women with abnormal cervical cytology referred for colposcopy: An observational study. Eur J Obstet Gynecol Reprod Biol [Internet]. 2013;169(2):387-91. https:\/\/doi.org\/10.1016\/j.ejogrb.2013.03.033","DOI":"10.1016\/j.ejogrb.2013.03.033"},{"key":"106678","doi-asserted-by":"crossref","unstructured":"Murad M, Lin L, Chu H, Hasan B, Alsibai R, Abbas A, et al. The association of sensitivity and specificity with disease prevalence: Analysis of 6909 studies of diagnostic test accuracy. CJMA. 2023. doi: https:\/\/doi.org\/10.1503\/cmaj.221802\/tab-related-content","DOI":"10.1503\/cmaj.221802"}],"container-title":["Revista Colombiana de Obstetricia y Ginecolog\u00eda"],"original-title":[],"link":[{"URL":"https:\/\/revista.fecolsog.org\/index.php\/rcog\/article\/download\/4510\/4137","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/revista.fecolsog.org\/index.php\/rcog\/article\/download\/4510\/4137","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,21]],"date-time":"2026-04-21T14:06:11Z","timestamp":1776780371000},"score":1,"resource":{"primary":{"URL":"https:\/\/revista.fecolsog.org\/index.php\/rcog\/article\/view\/4510"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,4,18]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,4,18]]}},"URL":"https:\/\/doi.org\/10.18597\/rcog.4510","relation":{},"ISSN":["2463-0225","0034-7434"],"issn-type":[{"value":"2463-0225","type":"electronic"},{"value":"0034-7434","type":"print"}],"subject":[],"published":{"date-parts":[[2026,4,18]]},"assertion":[{"value":"2026-04-18","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}},{"value":"Yes","order":0,"name":"peer_reviewed","label":"Peer Reviewed","group":{"name":"peer_review","label":"Peer Review"}},{"value":"Federaci\u00f3n Colombiana de Obstetricia y Ginecolog\u00eda","name":"publisher","label":"This article is maintained by"},{"value":"Revista Colombiana de Osbtetricia y Ginecolog\u00eda","name":"journaltitle","label":"Journal Title"},{"value":"Investigaci\u00f3n Original","name":"content_type","label":"Content Type"}]}}