The Impact of Therapeutic Improvements on the Value of Mass Screening for Early Detection of Disease: The Case of Cervical Cancer
The problem under study is the impact of survival-improvement on the value of mass-screening for early detection of disease. Two kinds of survival-improvement are defined: decrease in case-fatality, and increase in survival-time for fatal cases. The problem is investigated for cervical cancer screening, using the computer-programme MISCAN for simulation of mass screening and assuming a reduction of 30% in the case-fatality of local cervical cancer, and a doubling of survival for fatal cancer cases. Also, an example is given of how the results from a randomized clinical trial of a new treatment can be used for assessing the impact of this therapy on the effectiveness of mass screening. The general conclusion of the paper is that the effectiveness of cervical cancer screening will drop with improving therapy, especially for screening at older ages.
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