Comparative models of cervical cancer screening in Manitoba.

The laboratory system in Manitoba for routine cervical screening is outdated and costly. We developed a costing framework for the implementation of new cervical cancer screening technology models. The direct healthcare costs in the baseline model, the conventional Papanicolaou smear test, were compared with estimates of two newer technology platforms, liquid-based cytology and human papillomavirus (HPV) testing. The findings revealed that HPV testing as a primary screening model for women aged 30 years and older represented the least-cost strategy. Liquid-based cytology would be used for routine screening of women under 30 years of age and to triage women 30 years and older whose results were HPV positive.