The cost-effectiveness of human papillomavirus self-collection among cervical cancer screening non-attenders in El Salvador.
Prev Med
; 131: 105931, 2020 02.
Article
em En
| MEDLINE
| ID: mdl-31765712
ABSTRACT
Cervical cancer screening with human papillomavirus (HPV) DNA testing has been incorporated into El Salvador's national guidelines. The feasibility of home-based HPV self-collection among women who do not attend screening at the clinic (i.e., non-attenders) has been demonstrated, but cost-effectiveness has not been evaluated. Using cost and compliance data from El Salvador, we informed a mathematical microsimulation model of HPV infection and cervical carcinogenesis to conduct a cost-effectiveness analysis from the societal perspective. We estimated the reduction in cervical cancer risk, lifetime cost per woman (2017 US$), life expectancy, and incremental cost-effectiveness ratio (ICER, 2017 US$ per year of life saved [YLS]) of a program with home-based self-collection of HPV (facilitated by health promoters) for the 18% of women reluctant to screen at the clinic. The model was calibrated to epidemiologic data from El Salvador. We evaluated health and economic outcomes of the self-collection intervention for women aged 30 to 59â¯years, alone and in concert with clinic-based HPV provider-collection. Home-based self-collection of HPV was projected to reduce population cervical cancer risk by 14% and cost $1210 per YLS compared to no screening. An integrated program reaching 99% coverage with both provider- and home-based self-collection of HPV reduced cancer risk by 74% (compared to no screening), and cost $1210 per YLS compared to provider-collection alone. Self-collection facilitated by health promoters is a cost-effective strategy for increasing screening uptake in El Salvador.
Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Análise Custo-Benefício
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Infecções por Papillomavirus
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Detecção Precoce de Câncer
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Testes de DNA para Papilomavírus Humano
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Modelos Teóricos
Tipo de estudo:
Diagnostic_studies
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Guideline
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Health_economic_evaluation
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Prognostic_studies
/
Screening_studies
Limite:
Adult
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Female
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Humans
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Middle aged
País/Região como assunto:
America central
/
El salvador
Idioma:
En
Revista:
Prev Med
Ano de publicação:
2020
Tipo de documento:
Article