Cost-effectiveness analysis of human papillomavirus DNA testing and Pap smear for cervical cancer screening in a publicly financed health-care system

被引：17

作者：

Chow, I. H-I ^{[1
]}

Tang, C-H ^{[1
,2
]}

You, S-L ^{[3
,4
]}

Liao, C-H ^{[5
,6
]}

Chu, T-Y ^{[7
,8
]}

Chen, C-J ^{[3
,9
]}

Chen, C-A ^{[10
]}

Pwu, R-F ^{[1
,6
]}

机构：

[1] Taipei Med Univ, Sch Hlth Care Adm, Taipei, Taiwan

[2] Taipei Med Univ Hosp, Gynecol Res Ctr, Taipei, Taiwan

[3] Acad Sinica, Genom Res Ctr, Taipei 115, Taiwan

[4] Natl Def Med Ctr, Sch Publ Hlth, Taipei, Taiwan

[5] Natl Taiwan Univ, Inst Hlth Policy & Management, Taipei 10764, Taiwan

[6] Ctr Drug Evaluat, Taipei, Taiwan

[7] Tzu Chi Univ, Buddhist Tzu Chi Gen Hosp, Dept Obstet & Gynecol, Hualien, Taiwan

[8] Tzu Chi Univ, Buddhist Tzu Chi Gen Hosp, Ctr Cerv Canc Prevent, Hualien, Taiwan

[9] Natl Taiwan Univ, Grad Inst Epidemiol, Coll Publ Hlth, Taipei 10764, Taiwan

[10] Natl Taiwan Univ, Coll Med, Dept Obstet & Gynecol, Taipei 10764, Taiwan

来源：

BRITISH JOURNAL OF CANCER | 2010年 / 103卷 / 12期

关键词：

HPV DNA testing; Pap smear; cost-effectiveness analysis; cervical cancer; screening; CYTOLOGY; VACCINATION; STRATEGIES; BENEFITS; EFFICACY; SAMPLES; IMPACT;

D O I：

10.1038/sj.bjc.6605974

中图分类号：

R73 [肿瘤学];

学科分类号：

100214 ;

摘要：

OBJECTIVE: To evaluate the long-term cost-effectiveness of different strategies for human papillomavirus (HPV) DNA testing combined with Pap smear for cervical cancer screening in Taiwan. METHODS: This study adopts a perspective of Department of Health in cost-effectiveness analysis to compare a no-screening strategy with nine different screening strategies. These strategies comprise three screening tools (Pap smear alone, HPV DNA testing followed by Pap smear triage, and HPV DNA testing combined with Pap smear), and three screening intervals (annually, every 3 years, and every 5 years). Outcomes are life expectancy, quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs). Probabilistic sensitivity analyses (PSAs) were conducted to assess parameter uncertainty. RESULTS: When three times gross domestic product per capita is used as the decision threshold, all nine screening strategies were cost-effective compared with the no-screening strategy. Compared with the current screening strategy (an annual Pap smear), HPV DNA testing followed by Pap smear triage every 5 years and every 3 years were cost-effective. Results of PSA also indicated that a HPV DNA testing followed by Pap smear triage every 5 or every 3 years achieved the highest expected net benefits. CONCLUSIONS: Possible economic advantages are associated with extending the cervical cancer screening interval from one Pap smear annually to HPV DNA testing followed by Pap smear triage every 5 years with an ICER $ 1 247 000 per QALY gained, especially in a country with a publicly financed health-care system. British Journal of Cancer (2010) 103, 1773-1782. doi:10.1038/sj.bjc.6605974 www.bjcancer.com Published online 23 November 2010 (C) 2010 Cancer Research UK

引用

页码：1773 / 1782

页数：10

共 49 条

[1] Self-sampling versus physician-sampling for human papillomavirus testing [J].