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Cost-effectiveness of primarily human papillomavirus-based cervical cancer screening in settings with currently established Pap screening: a systematic review commissioned by the German Federal Ministry of Health.

Authors :
Mühlberger N
Sroczynski G
Esteban E
Mittendorf T
Miksad RA
Siebert U
Mühlberger, Nikolai
Sroczynski, Gaby
Esteban, Eva
Mittendorf, Thomas
Miksad, Rebecca A
Siebert, Uwe
Source :
International Journal of Technology Assessment in Health Care; Apr2008, Vol. 24 Issue 2, p184-192, 9p
Publication Year :
2008

Abstract

<bold>Objectives: </bold>The aim of this study was to summarize the current evidence for the cost-effectiveness of primarily human papillomavirus (HPV) -based cervical cancer screening in settings with already established Papanicolaou test (Pap) programs. Emphasis was placed on the German situation with annual Pap screening.<bold>Methods: </bold>Medical, economic, and health technology assessment (HTA) databases were systematically searched for cost-effectiveness studies comparing HPV to Pap screening. Study data were extracted, standardized, and summarized in cost-effectiveness plots contrasting HPV strategies to Pap screening with 1-, 2-, 3-, and 5-years interval. For each Pap setting, the likelihood of cost-effective HPV screening was assessed depending on willingness-to-pay.<bold>Results: </bold>We reviewed twelve decision-analytic cost-effectiveness models. Study results showed wide variation due to methodical heterogeneity. Data synthesis revealed that the cost-effectiveness of HPV screening depends on the interval of the established Pap screening strategy. In comparison with Pap screening every 2 years, only 25 percent of the HPV-based screening strategies were cost-effective. However, in comparison with Pap screening every 1, 3, or 5 years, 83 percent, 55 percent, and 92 percent of HPV screening strategies were cost-effective, respectively. Results for settings with annual Pap screening are based on models assuming 100 percent screening coverage.<bold>Conclusions: </bold>The introduction of HPV-based screening programs is cost-effective if the screening interval of the established Pap program exceeds 2 years. In settings with biennial Pap screening, introduction of HPV-based screening is unlikely to be cost-effective. Results also suggest cost-effectiveness of HPV-based screening in settings with annual Pap screening; however, this finding should be confirmed under realistic screening adherence assumptions. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
02664623
Volume :
24
Issue :
2
Database :
Complementary Index
Journal :
International Journal of Technology Assessment in Health Care
Publication Type :
Academic Journal
Accession number :
105814522
Full Text :
https://doi.org/10.1017/S0266462308080264