scholarly journals Cost effectiveness analysis of cervical cancer screening in women until age 70

2018 ◽  
Vol 7 (10) ◽  
pp. 3899
Author(s):  
James C. Quon
Keyword(s):  
Cervical Cancer ◽  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Task Force ◽  
Cost Benefit ◽  
Cost Effective ◽  
The United States ◽  
Screening Guidelines

Background: 2017 US Preventive Services Task Force guidelines for screening cervical cancer and pre-malignant lesions advise that screenings cease for women over age 65, with qualifications. Recent literature has identified significant discrepancies in rates of cervical cancer in older women – if hysterectomies in this patient population is accounted for, cervical cancer incidence does not decline with age as previously established. This adjusted incidence of cervical cancer necessitates a re-examination of current practice.Methods: This study seeks to demonstrate the utility of extending the cervical cancer screening age recommendations to age 70. Cost effectiveness will be estimated, from a payer perspective, of extending screening to age 70 for the United States women’s population in those who have not undergone hysterectomy or otherwise been treated for past cervical cancer or premalignancy. A Markov model was constructed to project outcomes in a hypothetical cohort of 10 000 women aged 65 to 70, with a time horizon of lifetime. A Probability Sensitivity Analysis determined the robustness of the result, and the Incremental Cost-effectiveness Ratio (ICER) is charted.Results: The economic evaluation of screening compared to none in this population was determined to be cost effective, with an ICER demonstrating a cost benefit, and Quality Adjusted Life Year (QALY) benefit, to extended screening.Conclusions: The sensitivity analysis confirms the robustness of this result. Implementing extended screening guidelines could potentially be a significant gain for both patients and society.

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 State of the Science: Screening, Surveillance, and Epidemiology of HPV-Related Malignancies

2021 ◽  
pp. 1-12
Author(s):  
Rahel Ghebre ◽  
J. Michael Berry-Lawhorn ◽  
Gypsyamber D’Souza
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
High Resolution ◽  
Cervical Cancer Screening ◽  
Task Force ◽  
Hpv Vaccination ◽  
Cancer Society ◽  
Screening Guidelines ◽  
Cancer Precursors ◽  
The U.S

Oropharyngeal, cervical, vulvar, and anal cancers share a common risk factor of HPV infection. HPV vaccination is currently recommended at age 11 or 12 to prevent new HPV infections for all genders with catch-up vaccination recommened up to age 26. Despite the known effectiveness of HPV vaccination to prevent HPV-related cancer, there is continued low uptake in the United States; only 40% of eligible persons were vaccinated in 2018, though rates are 70% among teenagers. Current American Cancer Society cancer screening guidelines recommend cervical cancer screening, but do not have specific recommendations for screening for other HPV-related cancers. Oropharyngeal cancer precursors have yet to be identified, and there are currently no routine screening tests for oropharyngeal cancer recommended by the U.S. Preventive Services Task Force. The U.S. Preventive Services Task Force and American Cancer Society recommend cervical cancer screening for women at average risk up to age 65, and screening guidelines do not currently differ by HPV vaccination status. Primary HPV DNA testing was first approved for cervical cancer screening in 2016 and was shown to be superior for cervical cancer prevention. Vulvar and anal cancer precursors have been identified, but optimal screening remains unclear. Examination of the anal canal and perianus is best performed by trained clinicians using high-resolution anoscopy, and effectiveness of using high-resolution anoscopy to detect and treat anal high-grade squamous intraepithelial lesions to prevent cancer is actively being researched. Current multistep approaches to control HPV-related malignancies include HPV vaccination coupled with cervical cancer screening or surveillance for oropharyngeal, vulvar, and anal cancers.

Cervical Cancer Screening Clinical Practice Guidelines in Oncology

2004 ◽  
Vol 2 (6) ◽  
pp. 570 ◽  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Current Method ◽  
The United States ◽  
Cervical Cytology ◽  
Screening Guidelines ◽  
Incidence And Mortality ◽  
Recent Version ◽  
Cytology Screening

Despite a significant decrease in the incidence and mortality of cervical carcinoma in the United States, 10,520 women are expected to develop the disease in 2004, with 3,900 expected deaths. Because cervical cytology screening is the current method for early detection of this neoplasm, the purpose of the NCCN Cervical Cancer Screening Guidelines is to provide direction for the evaluation and management of cervical cytology. For the most recent version of the guidelines, please visit NCCN.org

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 Primary High-Risk Human Papillomavirus Testing for Cervical Cancer Screening in the United States: Is It Time?

2018 ◽  
Vol 142 (6) ◽  
pp. 688-692 ◽  
Author(s):  
Melina B. Flanagan
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Pap Test ◽  
The United States ◽  
Screening Methods ◽  
Hpv Testing ◽  
Screening Guidelines

Context.— The most recent update to cervical cancer screening guidelines offers interim guidance on the use of primary human papillomavirus (HPV) screening, with algorithms for management of results. After decades of screening with pure cytology and a shorter time with adjunctive HPV or cotesting with Papanicolaou (Pap) test and HPV, this is a significant change to our screening methods. Objective.— To briefly review the history of cervical cancer screening, the evidence upon which these interim guidelines were based, the arguments for and against primary HPV testing, and the current state of the field. Data Sources.— Primary studies, review articles, and commentaries were reviewed. Conclusions.— While there is evidence both for and against primary HPV testing, there are a growing number of countries adopting the practice. It would be worthwhile to be informed and prepared for such a change in the United States as well.

Sign in / Sign up

Export Citation Format

Share Document