{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:10:04Z","timestamp":1788347404174,"version":"build-2803163510"},"reference-count":304,"publisher":"National Institute for Health and Care Research","issue":"8","license":[{"start":{"date-parts":[[2013,3,1]],"date-time":"2013-03-01T00:00:00Z","timestamp":1362096000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.nationalarchives.gov.uk\/doc\/non-commercial-government-licence\/non-commercial-government-licence.htm"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment programme","doi-asserted-by":"publisher","award":["11\/44\/01"],"award-info":[{"award-number":["11\/44\/01"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Technol Assess"],"abstract":"<jats:sec id=\"abs1-1\"><jats:title>Background<\/jats:title><jats:p>Women in England (aged 25\u201364 years) are invited for cervical screening every 3\u20135 years to assess for cervical intraepithelial neoplasia (CIN) or cancer. CIN is a term describing abnormal changes in the cells of the cervix, ranging from CIN1 to CIN3, which is precancerous. Colposcopy is used to visualise the cervix. Three adjunctive colposcopy technologies for examination of the cervix have been included in this assessment: Dynamic Spectral Imaging System (DySIS), the LuViva Advanced Cervical Scan and the Niris Imaging System.<\/jats:p><\/jats:sec><jats:sec id=\"abs1-2\"><jats:title>Objective<\/jats:title><jats:p>To determine the clinical effectiveness and cost-effectiveness of adjunctive colposcopy technologies for examination of the uterine cervix for patients referred for colposcopy through the NHS Cervical Screening Programme.<\/jats:p><\/jats:sec><jats:sec id=\"abs1-3\"><jats:title>Data sources<\/jats:title><jats:p>Sixteen electronic databases [Allied and Complementary Medicine Database (AMED), BIOSIS Previews, Cochrane Database of Systematic Reviews (CDSR), Cochrane Central Register of Controlled Trials (CENTRAL), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Database of Abstracts of Reviews of Effects (DARE), EMBASE, Health Management Information Consortium (HMIC), Health Technology Assessment (HTA) database; Inspec, Inside Conferences, MEDLINE, NHS Economic Evaluation Database (NHS EED), PASCAL, Science Citation Index Expanded (SCIE) and Science Citation Index (SCI) \u2013 Conference Proceedings], and two clinical trial registries [ClinicalTrials.gov and Current Controlled Trials (CCT)] were searched to September\u2013October 2011.<\/jats:p><\/jats:sec><jats:sec id=\"abs1-4\"><jats:title>Review methods<\/jats:title><jats:p>Studies comparing DySIS, LuViva or Niris with conventional colposcopy were sought; a narrative synthesis was undertaken. A decision-analytic model was developed, which measured outcomes in terms of quality-adjusted life-years (QALYs) and costs were evaluated from the perspective of the NHS and Personal Social Services with a time horizon of 50 years.<\/jats:p><\/jats:sec><jats:sec id=\"abs1-5\"><jats:title>Results<\/jats:title><jats:p>Six studies were included: two studies of DySIS, one study of LuViva and three studies of Niris. The DySIS studies were well reported and had a low risk of bias; they found higher sensitivity with DySIS (both the DySISmap alone and in combination with colposcopy) than colposcopy alone for identifying CIN2+\u2009disease, although specificity was lower with DySIS. The studies of LuViva and Niris were poorly reported and had limitations, which indicated that their results were subject to a high risk of bias; the results of these studies cannot be considered reliable. The base-case cost-effectiveness analysis suggests that both DySIS treatment options are less costly and more effective than colposcopy alone in the overall weighted population; these results were robust to the ranges tested in the sensitivity analysis. DySISmap alone was more costly and more effective in several of the referral groups but the incremental cost-effectiveness ratio (ICER) was never higher than \u00a31687 per QALY. DySIS plus colposcopy was less costly and more effective in all reasons for referral. Only indicative analyses were carried out on Niris and LuViva and no conclusions could be made on their cost-effectiveness.<\/jats:p><\/jats:sec><jats:sec id=\"abs1-6\"><jats:title>Limitations<\/jats:title><jats:p>The assessment is limited by the available evidence on the new technologies, natural history of the disease area and current treatment patterns.<\/jats:p><\/jats:sec><jats:sec id=\"abs1-7\"><jats:title>Conclusions<\/jats:title><jats:p>DySIS, particularly in combination with colposcopy, has higher sensitivity than colposcopy alone. There is no reliable evidence on the clinical effectiveness of LuViva and Niris. DySIS plus colposcopy appears to be less costly and more effective than both the DySISmap alone and colposcopy alone; these results were robust to the sensitivity analyses undertaken. Given the lack of reliable evidence on LuViva and Niris, no conclusions on their potential cost-effectiveness can be drawn. There is some uncertainty about how generalisable these findings will be to the population of women referred for colposcopy in the future, owing to the introduction of the human papillomavirus (HPV) triage test and uptake of the HPV vaccine.<\/jats:p><\/jats:sec><jats:sec id=\"abs1-8\"><jats:title>Study registration<\/jats:title><jats:p>PROSPERO Record CRD42011001614.<\/jats:p><\/jats:sec><jats:sec id=\"abs1-9\"><jats:title>Funding<\/jats:title><jats:p>The National Institute for Health Research Health Technology Assessment programme.<\/jats:p><\/jats:sec>","DOI":"10.3310\/hta17080","type":"journal-article","created":{"date-parts":[[2014,10,13]],"date-time":"2014-10-13T11:53:29Z","timestamp":1413201209000},"page":"i-239","update-policy":"https:\/\/doi.org\/10.3310\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Adjunctive colposcopy technologies for examination of the uterine cervix \u2013 DySIS, LuViva Advanced Cervical Scan and Niris Imaging System: a systematic review and economic evaluation"],"prefix":"10.3310","volume":"17","author":[{"given":"R","family":"Wade","sequence":"first","affiliation":[{"name":"CRD\/CHE Technology Assessment Group, Centre for Reviews and Dissemination, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E","family":"Spackman","sequence":"additional","affiliation":[{"name":"CRD\/CHE Technology Assessment Group, Centre for Health Economics, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Corbett","sequence":"additional","affiliation":[{"name":"CRD\/CHE Technology Assessment Group, Centre for Reviews and Dissemination, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S","family":"Walker","sequence":"additional","affiliation":[{"name":"CRD\/CHE Technology Assessment Group, Centre for Health Economics, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K","family":"Light","sequence":"additional","affiliation":[{"name":"CRD\/CHE Technology Assessment Group, Centre for Reviews and Dissemination, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R","family":"Naik","sequence":"additional","affiliation":[{"name":"Northern Gynaecological Oncology Centre, Gateshead, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M","family":"Sculpher","sequence":"additional","affiliation":[{"name":"CRD\/CHE Technology Assessment Group, Centre for Health Economics, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Eastwood","sequence":"additional","affiliation":[{"name":"CRD\/CHE Technology Assessment Group, Centre for Reviews and Dissemination, University of York, York, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2013,3]]},"reference":[{"key":"key20160715114643969_ref1-bib1","volume-title":"Cervical cancer statistics-UK","author":"Cancer Research UK","year":"2012"},{"key":"key20160715114643969_ref1-bib2","volume-title":"Colposcopy and programme management: guidelines for the NHS Cervical Screening Programme.","author":"NHS Cancer Screening Programmes (NHSCSP)","year":"2010","edition":"2nd edn."},{"key":"key20160715114643969_ref1-bib3","volume-title":"Adjunctive colposcopy technologies for examination of the uterine cervix \u2013 DySIS, LuViva Advanced Cervical Scan, Niris Imaging System and Zilico APX-100: final scope. 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