scholarly journals Research Article Strategies for cervical cancer screening in the scope of the Brazilian Unified National Health System

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
A.A.S. Reis ◽  
C.C.F. Araújo ◽  
E.G. da Silva ◽  
T.B. Alves ◽  
Y.M.F. Ternes ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Health System ◽  
Cervical Cancer Screening ◽  
National Health ◽  
National Health System ◽  
Research Article

Social Class Inequalities in the Utilization of Health Care and Preventive Services in Spain, a Country with a National Health System

2010 ◽  
Vol 40 (3) ◽  
pp. 525-542 ◽  
Author(s):  
Marco Garrido-Cumbrera ◽  
Carme Borrell ◽  
Laia Palència ◽  
Albert Espelt ◽  
Maica Rodríguez-Sanz ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Social Class ◽  
Health Services ◽  
Cervical Cancer Screening ◽  
National Health ◽  
Waiting Times ◽  
National Health System ◽  
Social Classes ◽  
Class Differences

In Spain, despite the existence of a National Health System (NHS), the utilization of some curative health services is related to social class. This study assesses (1) whether these inequalities are also observed for preventive health services and (2) the role of additional private health insurance for people of advantaged social classes. Using data from the Spanish National Health Survey of 2006, the authors analyze the relationships between social class and use of health services by means of Poisson regression models with robust variance, controlling for self-assessed health. Similar analyses were performed for waiting times for visits to a general practitioner (GP) and specialist. After controlling for self-perceived health, men and women from social classes IV-V had a higher probability of visiting the GP than other social classes, but a lower probability of visiting a specialist or dentist. No large class differences were observed in frequency of hospitalization or emergency services use, or in breast cancer screening or influenza vaccination; cervical cancer screening frequency was lower among women from social classes IV-V. The inequalities in specialist visits, dentist visits, and cervical cancer screening were larger among people with only NHS insurance than those with double health insurance. Social class differences in waiting times were observed for specialist visits, but not for GP visits. Men and women from social classes IV-V had longer waits for a specialist; this was most marked among people with only NHS insurance. Clearly, within the NHS, social class inequalities are still evident for some curative and preventive services. Further research is needed to identify the factors driving these inequalities and to tackle these factors from within the NHS. Priority areas include specialist services, dental care, and cervical cancer screening.

scholarly journals Cost-effectiveness of HPV-based cervical cancer screening in the public health system in Nicaragua

BMJ Open ◽  
2017 ◽  
Vol 7 (6) ◽  
pp. e015048 ◽  
Author(s):  
Nicole G Campos ◽  
Mercy Mvundura ◽  
Jose Jeronimo ◽  
Francesca Holme ◽  
Elisabeth Vodicka ◽  
...  
Keyword(s):  
Public Health ◽  
Cervical Cancer ◽  
Cost Effectiveness ◽  
Cancer Screening ◽  
Health System ◽  
Cervical Cancer Screening ◽  
Public Health System ◽  
The Public

scholarly journals Comparative Cost Analysis Of Cervical Cancer Screening Programme Based On Molecular Detection Of HPV In Spain

2021 ◽  
Author(s):  
Raquel Ibáñez ◽  
María Mareque ◽  
Rosario Granados ◽  
Daniel Andía ◽  
Marcial García-Rojo ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Screening ◽  
Cervical Cancer Screening ◽  
Molecular Detection ◽  
National Health System ◽  
Cross Sectional ◽  
Total Cost ◽  
Hpv Dna ◽  
Hpv Test ◽  
The Cost

Abstract Background: HPV cervical cancer screening (CCS) must use validated HPV tests based on the molecular detection of either viral mRNA (Aptima HPV Assay – AHPV) or DNA. AHPV has demonstrated the same cross-sectional and longitudinal sensitivity for the detection of HSIL/CIN2+ lesions but with greater specificity than HPV-DNA tests. The study aimed to estimate the total costs of a CCS with a primary HPV test based on the detection of mRNA compared to DNA in women aged 35-65 years for the National Health System.Methods: A decision-tree-based model to estimate the cost of the CCS until the first colposcopy was designed based on Spanish CCS guidelines. The total cost (€,2019) for CCS with AHPV or DNA tests (HC2 and Cobas) was calculated, including HPV test, liquid-based cytology (LBC) and colposcopy, for a population of 7,263,529 women aged 35-65 years (assuming 70% coverage). Clinical inputs derived from a literature review were validated by a multidisciplinary expert panel. Data from head-to-head studies between different HPV tests were selected. Results: The use of AHPV showed reduction of 290,541 (-35%) and 355,913 (-40%) LBC compared to HC2 or Cobas, respectively. Furthermore, AHPV avoided 151,699 (-47%) colposcopies vs HC2 and 151,165 (-47%) vs Cobas. The total cost of CCS was €282,747,877 with AHPV, €322,587,588 with HC2 and €324,614,490 with Cobas. Therefore, AHPV savings €-39,839,711 vs HC2 and €-41,866,613 vs Cobas.Conclusions: Assuming that 70% of women from 35-65 years attend the CCS programme, the cost of screening up to the first colposcopy using AHPV would provide cost savings of up to €41.9 million vs DNA tests in Spain.

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