Cost-Effectiveness Analysis of Liquid-Based Cytology and Human Papillomavirus Testing in Cervical Cancer Screening

Abstract

In the U.S. Army, cervix cancer screening performed with liquid-based cytology and reflex HPV testing of atypical squamous cells of undetermined significance performed every 2 years is cost-effective, especially when indirect costs are considered.

A Systematic Review of Economic Aspects of Cervical Cancer Screening Strategies Worldwide: Discrepancy between Economic Analysis and Policymaking

“…Methods for calculating the ICER in six articles were; cost/ QALY (Mandelblatt et al, 2002b, Berkhof et al, 2010Chuck, 2010;Chow et al, 2010;Vijayaraghavan et al, 2009;2010a), in 13 studies the ICER were estimated by cost/LYG (Brown and Garber, 1999;Maxwell et al, 2002;Mandelblatt et al, 2002a;Goldie et al, 2001;2004;Kim et al, 2005;Bidus et al, 2006;Andres-Gamboa et al, 2008;Kulasingam et al, 2009;Levin et al, 2010;Sroczynski et al, 2011;Burger et al, 2012). Two studies did not report their ICER (Bistoletti et al, 2008;de Kok et al, 2012).…”

“…Chuck et al remarked that Pap smear screening every three years for all Canadian women and HPV triage for women older than 30 years with ASCUS were the most cost-effective strategies (Chuck, 2010 (Maxwell et al, 2002;Bidus et al, 2006). Berkhof et al (2010) in the Netherlands, indicated that starting screening with HPV triage with 5 years interval was the most cost effective strategies (Berkhof et al, 2010).Vijayaraghavan in South Africa reported that coscreening with HPV testing was less costly and the most effective strategy (Vijayaraghavan et al, 2009).…”

“…We excluded some articles that did not include the interval in their analyses because they chose different intervals from our selected categories. Three studies suggested two year intervals of screening combined with a co-screening strategy (Mandelblatt et al, 2002b;Bidus et al, 2006;Sroczynski et al, 2011). Five articles recommended three-year intervals (Brown and Garber, 1999;Goldie et al, 2001, Maxwell et al, 2002Chuck, 2010;Vijayaraghavan et al, 2010a), and three selected co-screening every three years (Maxwell et al, 2002;Sherlaw-Johnson and Philips, 2004;Chuck, 2010).…”

“…From the point of view of economic aspect of articles in high income countries, four articles suggested 2 years interval of screening (Mandelblatt et al, 2002b;Goldie et al, 2004;Bidus et al, 2006;Sroczynski et al, 2011). Six articles proposed 3-5 years interval (Brown and Garber, 1999;Maxwell et al, 2002;Kim et al, 2005;Chuck, 2010;Vijayaraghavan et al, 2010b;Burger et al, 2012) and three articles showed that 5 years interval between screenings was cost effective (Kulasingam et al, 2009;Berkhof et al, 2010;de Kok et al, 2012).…”

“…Fourteen studies were categorized as a high income countries (Brown and Garber, 1999;Mandelblatt et al, 2002b;Maxwell et al, 2002;Goldie et al, 2004;Kim et al, 2005;Bidus et al, 2006;Bistoletti et al, 2008;Kulasingam et al, 2009;Berkhof et al, 2010;Chuck, 2010;Vijayaraghavan et al, 2010a;Sroczynski et al, 2011;Burger et al, 2012;de Kok et al, 2012). Six studies were designed in middle income countries (Goldie et al, 2001;Maxwell et al, 2002;Andres-Gamboa et al, 2008;Vijayaraghavan et al, 2009;Chow et al, 2010;Levin et al, 2010).…”