Additional, Unnecessary Tests Driving Cost of Pap Smear Up

Additional, Unnecessary Tests Driving Cost of Pap Smear Up

Laboratories offer 'improved' tests, which include combination of tests, some of unknown benefit

WEDNESDAY, Oct. 16 (HealthDay News) -- Ordering of unnecessary tests is one factor driving the costs of Papanicolaou smears up, with indications of the costs reaching $1,000, according to a perspective piece published in the Oct. 17 issue of the New England Journal of Medicine.

Noting that cervical cancer screening is one of the 20th century's public health successes, with the availability of a cheap and effective screening test, Cheryl Bettigole, M.D., M.P.H., from the CompleteCare Health Network in Bridgeton, N.J., discusses the increasing cost of screening.

The author notes that ordering of unnecessary tests is one of the biggest drivers of increasing health care costs. Laboratories are aware of this and offer "improved" tests, many of which involve combination panels that can be easily ordered and contain extensive lists of tests. Multiple laboratories are marketing the single-vial women's health test, which includes the Papanicolaou test, human papillomavirus test, and tests for other infections, including some for which there is no evidence of benefit. Neither the clinician nor the patient is alerted to the high costs of the tests. Furthermore, some laboratories charge inflated amounts to uninsured women, while offering discounts to insurers.

"We need to advocate for a system in which information about the cost and benefit of diagnostic tests is readily available to patients and providers at the point of care," Bettigole concludes.

Full Text (http://www.nejm.org/doi/full/10.1056/NEJMp1307295 )