Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim CoeditorIndividualAuthor
To the Editor: The article by Mr Brown and
Dr Garber1 contributes little to our understanding
of important issues relating to improved methods of screening for cervical
cancer. It relies on fundamentally unsound assumptions.
The Eddy model on which this study was based was designed to study screening
intervals, not cost-effectiveness. This flawed model was constructed on an
old database, which does not reflect the impact of the human papillomavirus
epidemic and did not screen patients younger than 35 years.2
Since cervical cancer has become such a rare disease, measuring changes in
life-years saved is not relevant.
Sedlacek TV. Cost-effectiveness of Methods to Enhance Sensitivity of Papanicolaou Testing. JAMA. 1999;282(15):1419-1420. doi:10-1001/pubs.JAMA-ISSN-0098-7484-282-15-jac90009