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Moving towards an organized cervical cancer screening: costs and impact
- Source :
- Dipòsit Digital de la UB, Universidad de Barcelona, The European Journal of Public Health
- Publication Year :
- 2018
- Publisher :
- Oxford Univ Press, 2018.
-
Abstract
- Background: HPV screening has been shown to be more cost-effective than cytology screening under most scenarios. Furthermore, it should be offered only in organized programmes with good quality assurance mechanisms. This study analyses the comparative cost of the current policy of opportunistic cytology screening vs. a hypothetical organized programme based on primary HPV screening. Methods: Total cervical cancer expenditure was defined as the sum of three cost elements: (i) direct (medical and non-medical) costs, obtained from a calibrated Markov model of the natural history of HPV and cervical cancer; (ii) programmatic costs, estimated based on other organized screening programmes; and (iii) indirect costs, extrapolated from previously published data. Results: Organized HPV screening at 5-year intervals costs consistently less across all coverage levels than opportunistic cytology screening at 3-year intervals. The current annual direct medical cost to the public health system of the opportunistic cytology at 40% coverage is estimated at (sic)33.2 per woman screened aged 25-64. Under an organized programme of primary HPV screening at 70% coverage, the cost is estimated to be (sic)18.4 per woman screened aged 25-64. Conclusion: Our study concludes that the economic resources currently devoted to providing opportunistic cytology screening to 40% of the target population at 3-year intervals could be more effectively used to screen 70% of the target population at 5-year intervals by switching to an organized programme based on primary HPV screening. This finding is of relevance to other European countries or regions with similar screening policies and health infrastructures.
- Subjects :
- Adult
medicine.medical_specialty
Càncer de coll uterí
Cost effectiveness
Cost-Benefit Analysis
MEDLINE
Uterine Cervical Neoplasms
Citologia
Target population
Cervical cancer screening
03 medical and health sciences
Indirect costs
0302 clinical medicine
Cervix cancer
Environmental health
medicine
Humans
Mass Screening
030212 general & internal medicine
Early Detection of Cancer
Cervical cancer
Primary Health Care
business.industry
Public health
Papillomavirus Infections
Public Health, Environmental and Occupational Health
Hpv screening
Health Care Costs
Middle Aged
medicine.disease
Markov Chains
3. Good health
Citology
Spain
030220 oncology & carcinogenesis
Screening
Female
business
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Dipòsit Digital de la UB, Universidad de Barcelona, The European Journal of Public Health
- Accession number :
- edsair.doi.dedup.....713b4ddf051c89403533b1cc4de9509d