scholarly journals Yes! To Scaling Up Cervical Cancer Screening With Self-Collection: But the Cost of HPV Screening Must Be Reduced

2021 ◽  
pp. 1327-1328
Author(s):  
Ann Marie Beddoe
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Scaling Up ◽  
Hpv Screening ◽  
The Cost

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

2008 ◽  
Vol 24 (02) ◽  
pp. 184-192 ◽  
Author(s):  
Nikolai Mühlberger ◽  
Gaby Sroczynski ◽  
Eva Esteban ◽  
Thomas Mittendorf ◽  
Rebecca A. Miksad ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cost Effective ◽  
Pap Screening ◽  
Screening Strategies ◽  
Hpv Screening ◽  
The Cost

Objectives: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.Methods: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.Results: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.Conclusions: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.

scholarly journals Impact of Patient Adherence and Test Performance on the Cost-Effectiveness of Cervical Cancer Screening in Developing Countries

2010 ◽  
Vol 20 (1) ◽  
pp. 35-42 ◽  
Author(s):  
Rebecca B. Perkins ◽  
Sarah M. Langrish ◽  
Linda J. Stern ◽  
James F. Burgess ◽  
Carol J. Simon
Keyword(s):  
Cervical Cancer ◽  
Developing Countries ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Test Performance ◽  
Patient Adherence ◽  
The Cost

scholarly journals Cost-effectiveness of a stepwise intervention to promote adherence to cervical cancer screening

2019 ◽  
Vol 30 (3) ◽  
pp. 543-552
Author(s):  
João Firmino-Machado ◽  
Djøra I Soeteman ◽  
Nuno Lunet
Keyword(s):  
Cervical Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Cost Effective ◽  
Effective Strategy ◽  
Face To Face ◽  
Provider Perspectives ◽  
Phone Calls ◽  
The Cost

Abstract Background Cervical cancer screening is effective in reducing mortality, but adherence is generally low. We aimed to investigate the cost-effectiveness of a stepwise intervention to promote adherence to cervical cancer screening in Portugal. Methods We developed a decision tree model to compare the cost-effectiveness of four competing interventions to increase adherence to cervical cancer screening: (i) a written letter (standard-of-care); (ii) automated short message service text messages (SMS)/phone calls/reminders; (iii) automated SMS/phone calls/reminders + manual phone calls; (iv) automated SMS/phone calls/reminders + manual phone calls + face-to-face interviews. The main outcome measure was cost per quality-adjusted life year (QALY) measured over a 5-year time horizon. Costs were calculated from the societal and provider perspectives. Results From the societal perspective, the optimal strategy was automated SMS/phone calls/reminders, below a threshold of €8171 per QALY; above this and below €180 878 per QALY, the most cost-effective strategy was automated SMS/phone calls/reminders + manual phone calls and above this value automated SMS/phone calls/reminders + manual phone calls + face-to-face interviews. From the provider perspective, the ranking of the three strategies in terms of cost-effectiveness was the same, for thresholds of €2756 and €175 463 per QALY, respectively. Conclusions Assuming a willingness-to-pay threshold of one time the national gross domestic product (€22 398/QALY), automated SMS/phone calls/reminders + manual phone calls is a cost-effective strategy to promote adherence to cervical cancer screening, both from the societal and provider perspectives.

scholarly journals Scaling up community-based cervical cancer screening in Cameroon employing a single visit approach

2020 ◽  
Vol 30 (9) ◽  
pp. 1455-1457
Author(s):  
Damien Grohar ◽  
Pierre Vassilakos ◽  
Khadidja Benkortbi ◽  
Evelyn Tincho ◽  
Bruno Kenfack ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Scaling Up ◽  
Community Based ◽  
Single Visit

PP62 Cost-Effectiveness Of Cervical Cancer Screening In Estonia

2019 ◽  
Vol 35 (S1) ◽  
pp. 49-49
Author(s):  
Triin Võrno ◽  
Kaja-Triin Laisaar ◽  
Terje Raud ◽  
Kai Jõers ◽  
Doris Meigas-Tohver ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Screening Program ◽  
Pap Test ◽  
Cancer Screening Program ◽  
Hpv Test ◽  
Cervical Cancer Screening Program ◽  
The Cost

IntroductionIn Estonia, organized cervical cancer screening program is targeted at women aged 30–55(59) years and Pap-tests are taken every five years. Since cervical cancer is associated with human papillomavirus (HPV), a number of countries have introduced the HPV-test as the primary method of screening. The objective of this study was to evaluate the cost-effectiveness of organized cervical cancer screening program in Estonia by comparing HPV- and Pap-test based strategies.MethodsFor the cost-effectiveness analysis, a Markov cohort model was developed. The model was used to estimate costs and quality-adjusted life-years (QALYs) of eight screening strategies, varying the primary screening test and triage scenarios, upper age limit of screening, and testing interval. Incremental cost-effectiveness ratios (ICERs) were calculated in comparison to current screening practice as well as to the next best option. Sensitivity analysis was performed by varying one or more similar parameter(s) at a time, while holding others at their base case value. The analysis was performed from the healthcare payer perspective adopting a five percent annual discount rate for both costs and utilities.ResultsIn the base-case scenario, ICER for HPV-test based strategies in comparison to the current screening practice was estimated at EUR 8,596–9,786 per QALY. For alternative Pap-test based strategies ICER was estimated at EUR 2,332–2,425 per QALY. In comparison to the next best option, HPV-test based strategies were dominated by Pap-test based strategies. At the cost-effectiveness threshold of EUR 10,000 per QALY Pap-testing every three years would be the cost-effective strategy for women participating in the screening program from age 30 to 63 (ICER being EUR 3,112 per QALY).ConclusionsDecreasing Pap-test based screening interval or changing to HPV-test based screening can both improve the effectiveness of cervical cancer screening program in Estonia, but based on the current cost-effectiveness study Pap-test based screening every three years should be preferred.

Clinical trial to implementation: Cost and effectiveness considerations for scaling up cervical cancer screening in low- and middle-income countries

2016 ◽  
Vol 7 ◽  
pp. 4-11 ◽  
Author(s):  
Sujha Subramanian ◽  
Rengaswamy Sankaranarayanan ◽  
Pulikkottil Okkuru Esmy ◽  
Jissa Vinoda Thulaseedharan ◽  
Rajaraman Swaminathan ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Scaling Up ◽  
Implementation Cost ◽  
Middle Income ◽  
Middle Income Countries ◽  
Low And Middle Income

scholarly journals Ohio Appalachian women's perceptions of the cost of cervical cancer screening

Cancer ◽  
2010 ◽  
Vol 116 (20) ◽  
pp. 4727-4734 ◽  
Author(s):  
Ann Scheck McAlearney ◽  
Paula H. Song ◽  
Dale A. Rhoda ◽  
Cathy Tatum ◽  
Stanley Lemeshow ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Women’S Perceptions ◽  
The Cost

scholarly journals Acceptability of human papillomavirus (HPV) self-sampling among never- and under-screened Indigenous and other minority women: a randomised three-arm community trial in Aotearoa New Zealand

2021 ◽  
Author(s):  
Naomi Brewer ◽  
Karen Bartholomew ◽  
Jane Grant ◽  
Anna Maxwell ◽  
Georgina McPherson ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
New Zealand ◽  
Cancer Screening ◽  
Usual Care ◽  
Cervical Cancer Screening ◽  
Trial Registration ◽  
Asian Women ◽  
Aotearoa New Zealand ◽  
Hpv Screening

AbstractBackgroundInternationally, self-sampling for human papillomavirus (HPV) has been shown to increase participation in cervical-cancer screening. In Aotearoa New Zealand, there are long-standing ethnic inequalities in cervical-cancer screening, incidence, and mortality; particularly for indigenous Māori women, as well as Pacific, and Asian women.MethodsWe invited never- and markedly under-screened (≥5 years overdue) 30-69-year-old Māori, Pacific, and Asian women to participate in an open-label, three-arm, community-based, randomised controlled trial, with a nested sub-study. We aimed to assess whether two specific invitation methods for self-sampling improved screening participation over usual care among the least medically served populations. Women were individually randomised 3:3:1 to: clinic-based self-sampling (CLINIC – invited to take a self-sample at their usual general practice); home-based self-sampling (HOME – mailed a kit and invited to take a self- sample at home); and usual care (USUAL – invited to attend a clinic for collection of a standard cytology sample). Neither participants nor research staff could be blinded to the intervention. In a subset of general practices, women who did not participate within three months of invitation were opportunistically invited to take a self-sample, either next time they attended a clinic or by mail.FindingsWe randomised 3,553 women: 1,574 to CLINIC, 1,467 to HOME, and 512 to USUAL. Participation was highest in HOME (14.6% among Māori, 8.8% among Pacific, and 18.5% among Asian) with CLINIC (7.0%, 5.3% and 6.9%, respectively) and USUAL (2.0%, 1.7% and 4.5%, respectively) being lower. In fully adjusted models, participation was statistically significantly more likely in HOME than USUAL: Māori OR=9.7, (95%CI 3.0-31.5); Pacific OR=6.0 (1.8-19.5); and Asian OR=5.1 (2.4-10.9). There were no adverse outcomes reported. After three months, 2,780 non-responding women were invited to participate in a non-randomised, opportunistic, follow-on substudy. After 6 months,192 (6.9%) additional women had taken a self-sample.InterpretationUsing recruitment methods that mimic usual practice, we provide critical evidence that self-sampling increases screening among the groups of women (never and under-screened) who experience the most barriers in Aotearoa New Zealand, although the absolute level of participation through this population approach was modest. Follow-up for most women was routine but a small proportion required intensive support.Trial registrationANZCTR Identifier: ACTRN12618000367246 (date registered 12/3/2018) https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=371741&isReview=true;UTN:U1111-1189-0531FundingHealth Research Council of New Zealand (HRC 16/405)Protocolhttp://publichealth.massey.ac.nz/assets/Uploads/Study-protocol-V2.1Self-sampling-for-HPV-screening-a-community-trial.pdf

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