Publication:
Cost effectiveness analysis of HPV primary screening and dual stain cytology triage compared with cervical cytology

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Issued Date

2019

Resource Type

Article

File Type

application/pdf

ISSN

20050380

DOI

10.3802/jgo.2019.30.e17

Other identifier(s)

2-s2.0-85062185437

Rights Holder(s)

Scopus

Bibliographic Citation

Journal of Gynecologic Oncology. Vol 30, No.2 (2019)

Suggested Citation

Termrungruanglert W., Khemapech N., Tantitamit T., Havanond P. Cost effectiveness analysis of HPV primary screening and dual stain cytology triage compared with cervical cytology. Journal of Gynecologic Oncology. Vol 30, No.2 (2019). doi:10.3802/jgo.2019.30.e17 Retrieved from: https://hdl.handle.net/20.500.14740/5450

Title

Cost effectiveness analysis of HPV primary screening and dual stain cytology triage compared with cervical cytology

Author(s)

Termrungruanglert W.
 Khemapech N.
 Tantitamit T.
 Havanond P.

Abstract

Objectives: To assess the clinical and cost-effectiveness of human papillomavirus (HPV) primary screening triage with p16/Ki-67 dual stain cytology compared to cytology. Methods: We conducted an Excel®-based budget impact model to estimate the preinvasive and invasive cervical cancer cases identified, mortality rate, direct medical costs, quality-adjusted life years (QALYs) and the incremental cost-effectiveness analysis of two strategies from the healthcare payer perspective. The study population is a cohort of women 30-65 years of age presenting for cervical screening. Results: HPV primary screening triage with p16/Ki-67 dual stain showed higher sensitivity without losing specificity compared to conventional Pap smear. The improving the screening performance leads to decrease the prevalence of precancerous lesion, annual incidence and mortality of cervical cancer. The incidence of cervical cancer case detected by new algorithm compared with conventional method were 31,607 and 38,927, respectively. In addition, the new algorithm was more effective and more costly (average QALY 24.03, annual cost $13,262,693) than conventional cytology (average QALY 23.98, annual cost $7,713,251). The incremental cost-effective ratio (ICER) per QALY gained was $1,395. The sensitivity analysis showed if the cost of cytology and HPV test increased three times, the ICER would fall to $303/QALY gained and increased to $4,970/QALY gained, respectively. Conclusion: Our model results suggest that screening by use of HPV genotyping test as a primary screening test combined with dual stain cytology as the triage of HPV positive women in Thai population 30-65 years old is expected to be more cost-effective than conventional Pap cytology. © 2019. Asian Society of Gynecologic Oncology, Korean Society of Gynecologic Oncology.

Subject(s)

Ki 67 antigen
 Protein p16
 Virus DNA
 Adult
 Aged
 Article
 Cancer incidence
 Cancer mortality
 Cohort analysis
 Controlled study
 Cost effectiveness analysis
 Cost of illness
 Diagnostic test accuracy study
 Emergency health service
 Female
 Human
 Human cell
 Intermethod comparison
 Major clinical study
 Mortality rate
 Papanicolaou test
 Papillomavirus infection
 Precancer
 Prevalence
 Quality adjusted life year
 Screening test
 Sensitivity and specificity
 Staining
 Uterine cervix cancer
 Uterine cervix cytology
 Comparative study
 Cost benefit analysis
 Early cancer diagnosis
 Economic model
 Economics
 Epidemiology
 Genetics
 Genotype
 Human papillomavirus type 16
 Human papillomavirus type 18
 Isolation and purification
 Middle aged
 Mortality
 Procedures
 Thailand
 Uterine cervix carcinoma in situ
 Uterine cervix tumor
 Vagina smear
 Virology
 Adult
 Aged
 Cervical Intraepithelial Neoplasia
 Cost-Benefit Analysis
 DNA, Viral
 Early Detection of Cancer
 Female
 Genotype
 Human papillomavirus 16
 Human papillomavirus 18
 Humans
 Middle Aged
 Models, Economic
 Quality-Adjusted Life Years
 Sensitivity and Specificity
 Thailand
 Uterine Cervical Neoplasms
 Vaginal Smears

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URI

https://hdl.handle.net/20.500.14740/5450

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Scopus: Year 1983-2021

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