Abstract
The study by the Alliance for Cervical Cancer Prevention Cost Working Group reported by Goldie et al. is biased against cytologic screening. Costs for cytologic tests are overestimated. Costs for human papillomavirus (HPV) tests are underestimated. Single-visit cytologic screening is not considered. The Alliance was awarded a $50-million gift from the Bill and Melinda Gates Foundation on the assumption that noncytologic screening tests constitute the most likely solution to the problem of cervical cancer in developing countries. This assumption constitutes a potential source of bias against cytology that should be disclosed. Similarly the partnership between the Program for Appropriate Technology in Health a study cosponsor and Digene which markets HPV tests should be disclosed. (excerpt)
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