Epidemiologic and Health Economic Evaluation of Cervical Cancer Screening in Rural China
Autor: | Chun-Xia Yang, Ying Wang, Siyuan Tao, Li Ma, Yuqian Zhao, Jinghe Lang, Yang Li, Fei Zhao, Ying Wen, You-Lin Qiao, Le Dang, Fang-Hui Zhao |
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Rok vydání: | 2020 |
Předmět: |
Adult
Rural Population 0301 basic medicine China medicine.medical_specialty Cost-Benefit Analysis Uterine Cervical Neoplasms Health benefits Cervical cancer screening 03 medical and health sciences 0302 clinical medicine Epidemiology medicine Screening method Humans Early Detection of Cancer Cervical cancer business.industry screening Incidence (epidemiology) General Medicine Middle Aged Prognosis Uterine Cervical Dysplasia medicine.disease Markov Chains rural China 030104 developmental biology Case-Control Studies 030220 oncology & carcinogenesis Cohort Economic evaluation Female Quality-Adjusted Life Years business Follow-Up Studies Research Article Demography |
Zdroj: | Asian Pacific Journal of Cancer Prevention : APJCP |
ISSN: | 2476-762X |
Popis: | Background Cervical cancer is preventable and curable by detected early and managed effectively. To explore the most economical and effective cervical cancer screening strategies would lay a solid foundation for reducing the health and economic burden of cervical cancer. Methods A Markov model was established for a cohort of 100,000 female to simulate the natural history of cervical cancer. 18 screening strategies were estimated including careHPV, Thin prep cytologic (TCT), Visual inspection with acetic acid/ Lugol's iodine (VIA / VILI), careHPV in series with VIA / VILI, careHPV in series with TCT, three methods parallel connection every 1, 3, 5 years respectively. Model outcomes included cumulative risk of incidence and death of cervical cancer, quality-adjusted life years (QALYs), cost-effectiveness ratios (CERs), incremental cost-effectiveness ratios (ICERs), cost-utility ratios (CURs) and benefits. Results According to the results of epidemiological analysis, careHPV similar to the parallel connection every 1 year achieved highest epidemiological effects via reducing the cumulative risk of onset and death by more than 98 %. In health-economic terms, CER among all the screening strategies ranged from -756.34 to 113040.3 Yuan per year and CUR ranged from -169.91 to 11968.27 Yuan per QALY. The benefit ranged from -1629 to 996 Yuan. The incremental cost-effectiveness analysis showed that three methods in parallel every 1 year, TCT every 1 year, VIA/VILI every 1, 3, 5 years and careHPV every 5 years were dominant strategies. Conclusion Considering the economic and health benefits of all the strategies, our results suggested careHPV every 3 or 5 years and VIA/VILI every 1 or 3 years eventually were more appropriate as screening methods in rural China. |
Databáze: | OpenAIRE |
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