Comparative cost analysis of cervical cancer screening programme based on molecular detection of HPV in Spain.
BMC Womens Health
; 21(1): 178, 2021 04 26.
Article
em En
| MEDLINE
| ID: mdl-33902553
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 versus HC2 and 151,165 (- 47%) versus 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 versus HC2 and - 41,866,613 versus Cobas.CONCLUSIONS:
Assuming that 70% of women from 35 to 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 versus DNA tests in Spain.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Colo do Útero
/
Infecções por Papillomavirus
Tipo de estudo:
Diagnostic_studies
/
Guideline
/
Health_economic_evaluation
/
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
/
Screening_studies
Limite:
Female
/
Humans
/
Pregnancy
País/Região como assunto:
Europa
Idioma:
En
Revista:
BMC Womens Health
Assunto da revista:
SAUDE DA MULHER
Ano de publicação:
2021
Tipo de documento:
Article
País de afiliação:
Espanha