Cost-Effectiveness Analysis of Human Papillomavirus DNA Testing and Pap Smear for Cervical Cancer Screening in a Publicly Financed Health-Care System
Resource
BRITISH JOURNAL OF CANCER v.103 n.12 pp.1773-1782
Journal
Yearbook of Obstetrics Gynecology and Women s Health
Pages
382-384
Date Issued
2010
Date
2010
Author(s)
CHOW, INES HANG-IAO
TANG, CHAO-HSIUN
YOU, SAN-LIN
CHU, TANG-YUAN
CHEN, CHIEN-JEN
CHEN, CHI-AN
PWU, RAOH-FANG
Abstract
OBJECTIVE: To evaluate the long-term cost-effectiveness of different strategies for human papillomavirus (HPV) DNA testing combined with Pap smear for cervical cancer screening in Taiwan. METHODS: This study adopts a perspective of Department of Health in cost-effectiveness analysis to compare a no-screening strategy with nine different screening strategies. These strategies comprise three screening tools (Pap smear alone, HPV DNA testing followed by Pap smear triage, and HPV DNA testing combined with Pap smear), and three screening intervals (annually, every 3 years, and every 5 years). Outcomes are life expectancy, quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs) . Probabilistic sensitivity analyses (PSAs) were conducted to assess parameter uncertainty. RESULTS: When three times gross domestic product per capita is used as the decision threshold, all nine screening strategies were cost-effective compared with the no-screening strategy. Compared with the current screening strategy (an annual Pap smear), HPV DNA testing followed by Pap smear triage every 5 years and every 3 years were cost-effective. Results of PSA also indicated that a HPV DNA testing followed by Pap smear triage every 5 or every 3 years achieved the highest expected net benefits. CONCLUSIONS: Possible economic advantages are associated with extending the cervical cancer screening interval from one Pap smear annually to HPV DNA testing followed by Pap smear triage every 5 years with an ICER $ 1 247 000 per QALY gained, especially in a country with a publicly financed health-care system.
Subjects
HPV DNA testing
Pap smear
cost-effectiveness analysis
cervical cancer
screening
SDGs
Type
journal article