Abstract
Background: Despite the increasing number of screening examinations performed for cervical cancer utilizing the Papanicolaou smear test (Pap test), few studies have examined whether this strategy is cost-effective in Korea. Objective: This study was conducted to evaluate the cost-effectiveness of cervical cancer screening strategies incorporating the Pap test based on age at the start and end of screening as well as screening interval. Materials and Methods: We designed four alternative screening strategies based on patient age when screening was started (20 or 30 years) and discontinued (lifetime, 79 years). Each strategy was assessed at screening intervals of 1, 2, 3, or 5 years. A Markov model was developed to determine the cost-effectiveness of the 16 possible cervical cancer screening strategies, and this was evaluated from a societal perspective. The main outcome measures were average lifetime cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Results: Compared with various strategies comprising younger starting age, discontinuation age, and longer screening intervals, strategies employing annual screening for cervical cancer starting at a target age of 30 years and above were the most cost-effective, with an ICER of 21,012.98 dollars per QALY gained (with a Korean threshold of 30,000,000 KRW or US$27,272). Conclusions: We found that annual screening for cervical cancer beginning at a target age of 30 years and above is most cost-effective screening strategy. Considering the potential economic advantages, more intense screening policies for cervical cancer might be favorable among countries with high rates of cervical cancer and relatively low screening costs.
| Original language | English |
|---|---|
| Pages (from-to) | 2317-2322 |
| Number of pages | 6 |
| Journal | Asian Pacific Journal of Cancer Prevention |
| Volume | 16 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - 2015 Jan 1 |
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Keywords
- Cancer screening
- Cervical cancer
- Economic evaluation
- HPV infection
- Pap smear test
ASJC Scopus subject areas
- Epidemiology
- Oncology
- Public Health, Environmental and Occupational Health
- Cancer Research
Cite this
Cost-effectiveness analysis of cervical cancer screening strategies based on the papanicolaou smear test in Korea. / Ko, Min Jung; Kim, Jimin; Kim, Younhee; Lee, Yoon Jae; Hong, Sung Ran; Lee, Jae Kwan.
In: Asian Pacific Journal of Cancer Prevention, Vol. 16, No. 6, 01.01.2015, p. 2317-2322.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Cost-effectiveness analysis of cervical cancer screening strategies based on the papanicolaou smear test in Korea
AU - Ko, Min Jung
AU - Kim, Jimin
AU - Kim, Younhee
AU - Lee, Yoon Jae
AU - Hong, Sung Ran
AU - Lee, Jae Kwan
PY - 2015/1/1
Y1 - 2015/1/1
N2 - Background: Despite the increasing number of screening examinations performed for cervical cancer utilizing the Papanicolaou smear test (Pap test), few studies have examined whether this strategy is cost-effective in Korea. Objective: This study was conducted to evaluate the cost-effectiveness of cervical cancer screening strategies incorporating the Pap test based on age at the start and end of screening as well as screening interval. Materials and Methods: We designed four alternative screening strategies based on patient age when screening was started (20 or 30 years) and discontinued (lifetime, 79 years). Each strategy was assessed at screening intervals of 1, 2, 3, or 5 years. A Markov model was developed to determine the cost-effectiveness of the 16 possible cervical cancer screening strategies, and this was evaluated from a societal perspective. The main outcome measures were average lifetime cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Results: Compared with various strategies comprising younger starting age, discontinuation age, and longer screening intervals, strategies employing annual screening for cervical cancer starting at a target age of 30 years and above were the most cost-effective, with an ICER of 21,012.98 dollars per QALY gained (with a Korean threshold of 30,000,000 KRW or US$27,272). Conclusions: We found that annual screening for cervical cancer beginning at a target age of 30 years and above is most cost-effective screening strategy. Considering the potential economic advantages, more intense screening policies for cervical cancer might be favorable among countries with high rates of cervical cancer and relatively low screening costs.
AB - Background: Despite the increasing number of screening examinations performed for cervical cancer utilizing the Papanicolaou smear test (Pap test), few studies have examined whether this strategy is cost-effective in Korea. Objective: This study was conducted to evaluate the cost-effectiveness of cervical cancer screening strategies incorporating the Pap test based on age at the start and end of screening as well as screening interval. Materials and Methods: We designed four alternative screening strategies based on patient age when screening was started (20 or 30 years) and discontinued (lifetime, 79 years). Each strategy was assessed at screening intervals of 1, 2, 3, or 5 years. A Markov model was developed to determine the cost-effectiveness of the 16 possible cervical cancer screening strategies, and this was evaluated from a societal perspective. The main outcome measures were average lifetime cost, incremental quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratio (ICER). Results: Compared with various strategies comprising younger starting age, discontinuation age, and longer screening intervals, strategies employing annual screening for cervical cancer starting at a target age of 30 years and above were the most cost-effective, with an ICER of 21,012.98 dollars per QALY gained (with a Korean threshold of 30,000,000 KRW or US$27,272). Conclusions: We found that annual screening for cervical cancer beginning at a target age of 30 years and above is most cost-effective screening strategy. Considering the potential economic advantages, more intense screening policies for cervical cancer might be favorable among countries with high rates of cervical cancer and relatively low screening costs.
KW - Cancer screening
KW - Cervical cancer
KW - Economic evaluation
KW - HPV infection
KW - Pap smear test
UR - http://www.scopus.com/inward/record.url?scp=84929193408&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84929193408&partnerID=8YFLogxK
U2 - 10.7314/APJCP.2015.16.6.2317
DO - 10.7314/APJCP.2015.16.6.2317
M3 - Article
VL - 16
SP - 2317
EP - 2322
JO - Asian Pacific Journal of Cancer Prevention
JF - Asian Pacific Journal of Cancer Prevention
SN - 1513-7368
IS - 6
ER -