An economic evaluation of two cervical screening algorithms in Belgium : HR-HPV primary compared to HR-HPV and liquid-based cytology co-testing
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc..
OBJECTIVE: To assess the costs and benefits of two algorithms for cervical cancer screening in Belgium (1) high-risk human papillomavirus (HR-HPV) primary screening and (2) HR-HPV and liquid-based cytology (LBC) co-testing.
METHODS: A decision tree was adapted from published work and parameterised using HORIZON study data and Belgian cost and population data. The theoretical model represents two different screening algorithms for a cohort of 577 846 women aged 25-64 attending routine cervical screening. Scenario analyses were used to explore the impact of including vaccinated women and alternative pricing approaches. Uncertainty analyses were conducted.
RESULTS: The cost per woman screened was €113.50 for HR-HPV primary screening and €101.70 for co-testing, representing a total cost of €65 588 573 and €58 775 083, respectively, for the cohort; a 10% difference. For one screening cycle, compared to HR-HPV primary, co-testing resulted in 13 173 more colposcopies, 67 731 more HR-HPV tests and 477 020 more LBC tests. Co-testing identified 2351 more CIN2+ cases per year (27% more than HR-HPV primary) and 1602 more CIN3+ cases (24% more than HR-HPV primary) than HR-HPV primary.
CONCLUSION: In Belgium, a co-testing algorithm could increase cervical pre-cancer detection rates compared to HR-HPV primary. Co-testing would cost less than HR-HPV primary if the cost of the HPV test and LBC were cost-neutral compared to the current cost of LBC screening but would cost more if the cost per HPV test and LBC were the same in both co-testing and HR-HPV primary strategies.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:33 |
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| Enthalten in: |
European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP) - 33(2024), 3 vom: 01. März, Seite 262-270 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Dombrowski, Caroline [VerfasserIn] |
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| Links: |
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| Anmerkungen: |
Date Completed 28.03.2024 Date Revised 28.03.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1097/CEJ.0000000000000856 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM364256745 |
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| 100 | 1 | |a Dombrowski, Caroline |e verfasserin |4 aut | |
| 245 | 1 | 3 | |a An economic evaluation of two cervical screening algorithms in Belgium |b HR-HPV primary compared to HR-HPV and liquid-based cytology co-testing |
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| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. | ||
| 520 | |a OBJECTIVE: To assess the costs and benefits of two algorithms for cervical cancer screening in Belgium (1) high-risk human papillomavirus (HR-HPV) primary screening and (2) HR-HPV and liquid-based cytology (LBC) co-testing | ||
| 520 | |a METHODS: A decision tree was adapted from published work and parameterised using HORIZON study data and Belgian cost and population data. The theoretical model represents two different screening algorithms for a cohort of 577 846 women aged 25-64 attending routine cervical screening. Scenario analyses were used to explore the impact of including vaccinated women and alternative pricing approaches. Uncertainty analyses were conducted | ||
| 520 | |a RESULTS: The cost per woman screened was €113.50 for HR-HPV primary screening and €101.70 for co-testing, representing a total cost of €65 588 573 and €58 775 083, respectively, for the cohort; a 10% difference. For one screening cycle, compared to HR-HPV primary, co-testing resulted in 13 173 more colposcopies, 67 731 more HR-HPV tests and 477 020 more LBC tests. Co-testing identified 2351 more CIN2+ cases per year (27% more than HR-HPV primary) and 1602 more CIN3+ cases (24% more than HR-HPV primary) than HR-HPV primary | ||
| 520 | |a CONCLUSION: In Belgium, a co-testing algorithm could increase cervical pre-cancer detection rates compared to HR-HPV primary. Co-testing would cost less than HR-HPV primary if the cost of the HPV test and LBC were cost-neutral compared to the current cost of LBC screening but would cost more if the cost per HPV test and LBC were the same in both co-testing and HR-HPV primary strategies | ||
| 650 | 4 | |a Journal Article | |
| 700 | 1 | |a Bourgain, Claire |e verfasserin |4 aut | |
| 700 | 1 | |a Ma, Yixuan |e verfasserin |4 aut | |
| 700 | 1 | |a Meiwald, Anne |e verfasserin |4 aut | |
| 700 | 1 | |a Pinsent, Amy |e verfasserin |4 aut | |
| 700 | 1 | |a Weynand, Birgit |e verfasserin |4 aut | |
| 700 | 1 | |a Turner, Katy M E |e verfasserin |4 aut | |
| 700 | 1 | |a Huntington, Susie |e verfasserin |4 aut | |
| 700 | 1 | |a Adams, Elisabeth J |e verfasserin |4 aut | |
| 700 | 1 | |a Bogers, Johannes |e verfasserin |4 aut | |
| 700 | 1 | |a Croes, Romaric |e verfasserin |4 aut | |
| 700 | 1 | |a Sahebali, Shaira |e verfasserin |4 aut | |
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