Letters Section Editor: Robert M. Golub, MD, Senior Editor.
In Reply: Dr Boncz suggests that short-term costs will undermine implementation of screening programs in countries with transitional economies or low resources. We appreciate the difficulties of introducing new health policies, but note that screen-and-treat strategies are more cost-effective than conventional cytology-based screening approaches. The cost-effectiveness of a variety of cervical cancer prevention strategies, including screen-and-treat, has been evaluated for India, Kenya, Peru, South Africa, and Thailand.1 In contrast to the common notion that cervical cancer screening is too expensive for low-resource settings, this analysis found that screen-and-treat programs are as cost-effective as other widely accepted public health interventions such as hepatitis B immunization and the prevention of malaria through the use of bed nets.
Wright TC, Kuhn L, Denny L. Prevention of Cervical Cancer in Low-Resource Settings—Reply. JAMA. 2006;295(11):1248-1249. doi:10.1001/jama.295.11.1249-a