The impact on women’s health and the cervical cancer screening budget of primary HPV screening with dual-stain cytology triage in Belgium

Abstract

Dual stain cytology, or "diagnostic cytology", offers a significant increase in sensitivity compared to cytology, with a slight decrease in specificity. This can reduce additional investigations like colposcopies, biopsies, and follow-up visits. Cervical cancer screening for women between 25 and 65 years of age with diagnostic cytology is estimated to reduce the incidence of cervical cancer by 36% and reduce annual cervical cancer mortalities by 40%. The reduced number of screening visits and the decrease in incidence and mortality will improve quality of life. In this article, a model was created to evaluate the cost-effectiveness of diagnostic cytology for Belgium. In this approach, precancerous cells are more likely to be immediately identified during the first screening visit. This reduces both the number and frequency of follow-up visits required. After two cycles (6 years), the prevalence of CIN and cervical cancer is decreased significantly in the screened population. At a population level, these shifts can reduce the screening budget by 21%, resulting in savings of 5.3 million euro a year in Belgium. Diagnostic cytology benefits all stakeholders involved in cervical cancer screening.

Budget impact analysis of cervical cancer screening in Portugal: comparison of cytology and primary HPV screening strategies

“…It improves the detection of CIN2-3 and CxCa, displays better clinical outcomes and creates substantial cost-savings for the Portuguese healthcare system. The results are in line with similar health economic outcome research (HECON) studies [36][37][38][39] and support the current clinical consensus on the move towards molecular screening for cervical cancer not just in Portugal but also other European countries. Nevertheless, as this study is based on a computer-based model cohort, a randomized clinical trial or real-world studies with randomized samples and appropriate methodologies are needed as further research to generalize these results to the population.…”

A model to evaluate the costs and clinical effectiveness of human papilloma virus screening compared with annual papanicolaou cytology in Germany

“…Increased acquisition costs for new technologies may be defrayed by improved screening performance and a reduction in costs for treating cervical cancer. A Belgian study estimated budgetary savings of about 21% with dual-stain cytology triage [34]. The model showed HPV screening potentially achieves annual cost savings compared with Pap screening, when office cost is minimized and the interval length is 5 years.…”

Economic burden and treatment patterns of gynecologic cancers in the United States: evidence from the Medical Expenditure Panel Survey 2007–2014

“…To fill the gap for the non-elderly, this study includes all adults with gynecologic cancers to examine their treatment patterns. Economic burden studies of gynecologic cancer were also conducted using claims data from one large health plan [12] and multiple datasets in a single state [13,14]. To our knowledge, no study quantifies direct medical spending and describes treatment patterns of gynecologic cancers by cancer site at the national level in the United States.…”