Publication: Cost-Effectiveness of Primary HPV Screening Strategies and Triage With Cytology or Dual Stain for Cervical Cancer
3
0
Issued Date
2020
Resource Type
File Type
application/pdf
ISSN
10732748
Other identifier(s)
2-s2.0-85084327993
Rights Holder(s)
มหาวิทยาลัยศรีนครินทรวิโรฒ
Bibliographic Citation
Cancer Control. Vol 27, No.1 (2020)
Suggested Citation
Tantitamit T., Khemapech N., Havanond P., Termrungruanglert W. Cost-Effectiveness of Primary HPV Screening Strategies and Triage With Cytology or Dual Stain for Cervical Cancer. Cancer Control. Vol 27, No.1 (2020). doi:10.1177/1073274820922540 Retrieved from: https://hdl.handle.net/20.500.14740/4974
Abstract
To identify the optimal cost-effective strategy for cervical cancer screening program in Thailand by comparing the different algorithms which based on the use of primary human papilloma virus (HPV) assay. We use a Microsoft Excel–based spreadsheet to calculate the accumulated cases of preinvasive and invasive cervical cancer and the budget impact of each screening program. The model was developed to determine the cost-effectiveness of 3 screening strategies: pooled HPV test with reflex liquid-based cytology triage, HPV genotyping with reflex p16/ki67 dual stain cytology, and pooled HPV test with dual stain. The main outcomes were the total cost, incremental quality-adjusted life years (QALYs) and incremental cost-effectiveness ratios (ICERs). Strategy entailing primary HPV genotyping and reflex dual stain cytology is the least costly strategy (total cost US$37 893 407) and provides the similar QALY gained compared to pooled high-risk HPV testing with reflex dual stain (Average QALY 24.03). Pooled HPV test with reflex dual staining is more costly compared to strategy without reflex dual staining. The ICER was US$353.40 per QALY gained. One-way sensitivity analysis showed that the model is sensitive to the cost of dual stain and the cost of cancer treatment. Decreasing the incidence of cervical cancer case and increasing the QALYs can be successful by using dual stain cytology as the triage test for pooled HPV test or HPV genotyping. The result of our analysis favors the use of HPV genotyping with the reflex dual stain as it offers the most QALY at the lowest cost. © The Author(s) 2020.
Subject(s)
Ki 67 antigen
Adult
Aged
Article
Cancer incidence
Cancer screening
Cancer therapy
Cohort analysis
Computer model
Cost effectiveness analysis
Cytology
Female
Genotype
Health care cost
Human
Papanicolaou test
Quality adjusted life year
Treatment outcome
Tumor invasion
Uterine cervix cancer
Uterine cervix carcinoma in situ
Cost benefit analysis
Cytology
Economics
Genotyping technique
Mass screening
Middle aged
Papillomavirus infection
Pathology
Procedures
Statistical model
Thailand
Uterine cervix tumor
Virology
Adult
Cost-Benefit Analysis
Cytological Techniques
Female
Genotyping Techniques
Health Expenditures
Humans
Mass Screening
Middle Aged
Models, Econometric
Neoplasm Invasiveness
Papillomavirus Infections
Quality-Adjusted Life Years
Thailand
Uterine Cervical Neoplasms
Adult
Aged
Article
Cancer incidence
Cancer screening
Cancer therapy
Cohort analysis
Computer model
Cost effectiveness analysis
Cytology
Female
Genotype
Health care cost
Human
Papanicolaou test
Quality adjusted life year
Treatment outcome
Tumor invasion
Uterine cervix cancer
Uterine cervix carcinoma in situ
Cost benefit analysis
Cytology
Economics
Genotyping technique
Mass screening
Middle aged
Papillomavirus infection
Pathology
Procedures
Statistical model
Thailand
Uterine cervix tumor
Virology
Adult
Cost-Benefit Analysis
Cytological Techniques
Female
Genotyping Techniques
Health Expenditures
Humans
Mass Screening
Middle Aged
Models, Econometric
Neoplasm Invasiveness
Papillomavirus Infections
Quality-Adjusted Life Years
Thailand
Uterine Cervical Neoplasms