HPV testing for cervical cancer screening appears more cost-effective than Papanicolau cytology in Mexico

Abstract

ObjectiveTo determine the incremental costs and effects of different HPV testing strategies, when compared to Papanicolau cytology (Pap), for cervical cancer screening in Mexico.MethodsA cost-effectiveness analysis (CEA) examined the specific costs and health outcomes associated with (1) no screening; (2) only the Pap test; (3) only self-administered HPV; (4) only clinician administered HPV; and (5) clinician administered HPV plus the Pap test. The costs of self- and clinician-HPV testing, as well as with the Pap test, were identified and quantified. Costs were reported in 2008 US dollars. The health outcome associated with these screening strategies was defined as the number of high-grade cervical intraepithelial neoplasia or cervical cancer cases detected. This CEA was performed using the perspective of the Mexican Institute of Social Security (IMSS) in Morelos, Mexico.ResultsScreening women between the ages of 30–80 for cervical cancer using clinical-HPV testing or the combination of clinical-HPV testing, and the Pap is always more cost-effective than using the Pap test alone.ConclusionsThis CEA indicates that HPV testing could be a cost-effective screening alternative for a large health delivery organization such as IMSS. These results may help policy-makers implement HPV testing as part of the IMSS cervical cancer screening program.

Prevalence of Human Papillomavirus in Women from the State of Michoacan, Mexico, Showed High Frequency of Unusual Virus Genotypes

“…18 Moreover, it was reported that PAP combined with HPV test increases the capability to identify cervical cancer 13,19,20 .…”

Cost-Effectiveness of Korea's National Cervical Cancer Screening Program

“…Increasing the uptake of cervical cancer screening is especially important because even though the ICER of adding vaccination to the Pap smear screening would be an cost-effective option, women of low socioeconomic status are less likely to participate in screening or to be able to afford the vaccination (Konno et al, 2008;Park et al, 2011;Praditsitthikorn et al, 2011;Yamamoto et al, 2012). The cost-effectiveness of vaccination in combination with frequent or infrequent screening by the NCSP needs to be evaluated, in light of young women's low screening participation rate and :http://dx.doi.org/10.7314/APJCP.2013.14.7.4329 Cost-Effectiveness of Cervical Cancer Screening Recently, the HPV-DNA screening test has attracted public attention, especially in developing countries, as a potentially more cost-effective alternative to the Pap smear (Levin et al, 2010;Flores et al, 2011). It may not be feasible for all women to receive regular Pap smears throughout their lives.…”

“…It may not be feasible for all women to receive regular Pap smears throughout their lives. Moreover, although the Pap smear is inexpensive, it is less accurate than the HPV-DNA test; therefore, screening at wider intervals with the highlysensitive HPV-DNA test may be more cost-effective than the current system (Gravitt et al, 2010;Levin et al, 2010;Chen et al, 2011;Flores et al, 2011;Shi et al, 2011). While HPV-DNA tests are not covered under the current NCSP, previous studies comparing screening methods have reported that the sensitivity of the Pap smear was improved markedly in combination with the HPV-DNA test (Kim et al, 2013).…”

Preventive Strategies against Human Papillomaviruses

“…Moreover, FDA and WHO have recommended these tests to be used in first-line primary screening. They can be used both in adjunct to cytology assays or alone for screening purpose [32]. Other mentioned tests are in the process of validation on large and small cohorts but they still need approval from FDA and other relevant governing bodies.…”