The cost-effectiveness of implementing HPV testing for cervical cancer screening in El Salvador

Nicole G. Campos, Mauricio Maza, Karla Alfaro, Julia C. Gage, Philip E. Castle, Juan C. Felix, Rachel Masch, Miriam Cremer, Jane J. Kim

Research output: Contribution to journalArticle

4 Scopus citations

Abstract

Objective: To assess the cost-effectiveness of HPV-based screening and management algorithms for HPV-positive women in phase 2 of the Cervical Cancer Prevention in El Salvador (CAPE) demonstration, relative to the status quo of Pap-based screening. Methods: Data from phase 2 of the CAPE demonstration (n=8000 women) were used to inform a mathematical model of HPV infection and cervical cancer. The model was used to project the lifetime health and economic outcomes of HPV testing every 5 years (age 30–65 years), with referral to colposcopy for HPV-positive women; HPV testing every 5 years (age 30–65 years), with immediate cryotherapy for eligible HPV-positive women; and Pap testing every 2 years (age 20–65 years), with referral to colposcopy for Pap-positive women. Results: Despite slight decreases in the proportion of HPV-positive women who received treatment relative to phase 1, the health impact of screening in phase 2 remained stable, reducing cancer risk by 58.5%. As in phase 1, HPV testing followed by cryotherapy for eligible HPV-positive women remained the least costly and most effective strategy (US$490 per year of life saved). Conclusion: HPV-based screening followed by immediate cryotherapy in all eligible women would be very cost-effective in El Salvador.

Original languageEnglish (US)
Pages (from-to)40-46
Number of pages7
JournalInternational Journal of Gynecology and Obstetrics
Volume145
Issue number1
DOIs
StatePublished - Apr 2019

Keywords

  • Cancer screening
  • Cost-effectiveness analysis
  • Decision analysis
  • El Salvador
  • HPV DNA tests
  • Human papillomavirus (HPV)
  • Mathematical model
  • Uterine cervical neoplasms

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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