TY - JOUR
T1 - Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia
AU - Andrés-Gamboa, Oscar
AU - Chicaíza, Liliana
AU - García-Molina, Mario
AU - Díaz, Jorge
AU - González, Mauricio
AU - Murillo, Raúl
AU - Ballesteros, Mónica
AU - Sánchez, Ricardo
PY - 2008
Y1 - 2008
N2 - Objective: To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia. Material and Methods: The National Cancer Institute of Colombia (NCIC) in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effectiveness ratios were estimated and sensitivity analyses were conducted for key parameters. Results: Depending on the screening strategy a 69-81% mortality reduction might be expected. The HPV DNA testing every five years is a cost-effective strategy (Incremental Cost-Effectiveness Ratio (ICER): USD$44/YLS) if the cost per test is under USD$31. The effectiveness was sensitive to coverage and primarily to follow-up. Conclusions: HPV DNA testing is a cost-effective alternative for screening in Colombia. Not only high coverage but high follow-up rates are critical for successful screening programs.
AB - Objective: To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia. Material and Methods: The National Cancer Institute of Colombia (NCIC) in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effectiveness ratios were estimated and sensitivity analyses were conducted for key parameters. Results: Depending on the screening strategy a 69-81% mortality reduction might be expected. The HPV DNA testing every five years is a cost-effective strategy (Incremental Cost-Effectiveness Ratio (ICER): USD$44/YLS) if the cost per test is under USD$31. The effectiveness was sensitive to coverage and primarily to follow-up. Conclusions: HPV DNA testing is a cost-effective alternative for screening in Colombia. Not only high coverage but high follow-up rates are critical for successful screening programs.
KW - Colombia
KW - Cost-benefit analysis
KW - Mass screening
KW - Uterine cervical neoplasms
UR - http://www.scopus.com/inward/record.url?scp=48649092599&partnerID=8YFLogxK
U2 - 10.1590/S0036-36342008000400005
DO - 10.1590/S0036-36342008000400005
M3 - Article
C2 - 18670718
AN - SCOPUS:48649092599
SN - 0036-3634
VL - 50
SP - 276
EP - 285
JO - Salud Publica de Mexico
JF - Salud Publica de Mexico
IS - 4
ER -
