The German Cervical Cancer Screening Model: development and validation of a decision-analytic model for cervical cancer screening in Germany

• DOI: 10.1093/eurpub/cki163
• Publication Date: 2006-02-10T01:14:15Z
• Authors: Uwe Siebert; Gaby Sroczynski; Peter Hillemanns; Jutta Engel; Roland Stabenow; Christa Stegmaier; Kerstin Voigt; Bernhard Gibis; Dieter Hölzel; Sue J. Goldie
• Keywords: Adult; Vaginal Smears; Adolescent; Uterine Cervical Neoplasms; Middle Aged; Markov Chains; Decision Support Techniques; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; Germany; Humans; Mass Screening; Female; Papanicolaou Test

Background: We sought to develop and validate a decision-analytic model for the natural history of cervical cancer German health care context apply it screening. Methods: developed Markov screening in context. The reflects current practice standards screening, diagnostic follow-up treatment regarding its precursors. Data disease progression survival were obtained from literature registries. Accuracy Papanicolaou (Pap) testing was based on meta-analyses. performed internal external validation using observed epidemiological data unscreened women different predicts life expectancy, incidence detected cases, lifetime risks mortality. Results: predicted risk 3.0% mortality 1.0%, with peak 84/100 000 at age 51 years. These results similar registries, other international models. Based our model, annual Pap could prevent 98.7% diagnosed cases 99.6% deaths due completely adherent compliant treatment. Extending interval 1 year 2, 3 or 5 years resulted reduced effectiveness. Conclusions: This provides tool evaluating long-term effectiveness tests strategies.