Cost-effectiveness analysis study of HPV testing as a primary cervical cancer screening in Thailand

Autor: Tanitra Tantitamit, Piyalamporn Havanond, Suleeporn Sangrajrang, Wichai Termrungruanglert, Nipon Khemapech, Piyawat Laowahutanont
Jazyk: angličtina
Rok vydání: 2017
Předmět:
medicine.medical_specialty
Population
Papanicolaou stain
lcsh:Gynecology and obstetrics
lcsh:RC254-282
03 medical and health sciences
Liquid based cytology
0302 clinical medicine
Cytology
medicine
030212 general & internal medicine
education
health care economics and organizations
lcsh:RG1-991
Gynecology
Cervical cancer
Colposcopy
education.field_of_study
medicine.diagnostic_test
Cost effectiveness analysis
business.industry
Obstetrics
HPV infection
Obstetrics and Gynecology
Cost-effectiveness analysis
medicine.disease
lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens
female genital diseases and pregnancy complications
Markov model
Oncology
Virtual Special Section on Gynecologic Cancers in Resource-constrained Countries
Edited by Linus Chuang
030220 oncology & carcinogenesis
Liquid-based cytology
Screening
business
Human papillomavirus testing
Zdroj: Gynecologic Oncology Reports, Vol 22, Iss C, Pp 58-63 (2017)
Gynecologic Oncology Reports
ISSN: 2352-5789
Popis: Objectives The aim of this study is to compare the cost and benefit of four different cervical cancer screening strategies involving primary HPV 16/18 genotyping, hrHPV testing alone and cytology for detecting CIN2 +. Methods Economical analysis using Markov modeling approach to combine the epidemiological data from current population-based study of The National Cancer Institute of Thailand. A cohort of 100,000 hypothetical female population age 30–65 years was simulated in each strategy. The compared strategies are HPV 16/18 genotyping with reflexed cytology, hrHPV testing alone followed by colposcopy, Papanicolaou standard cytology and liquid based cytology followed by colposcopy. The interval of screening was 5 years' interval. The main outcomes were defined as a number of CIN2 + cases and cost per 100,000 women screening over 35 years. Results Model predictions indicated that, the most cost-effectiveness strategy is hrHPV testing alone by reducing cost and also increase CIN2 + detection rate. It identify an additional 130 cases and decrease cost by 46,950,840 THB (1,394,441 USD) per 100,000 women screened when compared to HPV 16/18 genotyping. Compared with cytology, hrHPV testing decrease cost by 51,279,781 THB (1,523,011 USD) and detected more 506 cases of CIN2 +. From sensitivity analysis, the cost of HPV testing, cost of colposcopy, incidence of HPV infection and sensitivity of cytology may affect the results. (1 USD = 33.67 Baht). Conclusion The results of this cost-effectiveness analysis support the full scale implementation of HPV testing as a primary cervical cancer screening in Thailand.
Highlights • This is the first economic study of HPV testing as a screening method in Thailand. • The primary HPV testing is more effective than cytology method. • The most cost-effectiveness strategy is HR-HPV testing alone.
Databáze: OpenAIRE
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