Determining the cost-effectiveness of mass screening for cervical cancer using common analytic models.
OBJECTIVE
To estimate the cost per life-year saved (cost-effectiveness ratio [CER]) for cervical cancer and to evaluate the influence of the decreased incidence upon the cost per life-year saved.


METHODS
We established hypothetical cohorts at 10-year intervals between 30 and 79 years of age, each of which consisted of 100,000 asymptomatic female subjects, and estimated the cost and effect of single mass screening for cervical cancer. To investigate the influence on CER, we performed a sensitivity analysis of each item, including the consultation rate for further examination, prevalence rate and cost of medical treatment.


RESULTS
The estimated CER per one expected life-year of survival was lowest for subjects in their 30s and highest for those in their 70s. The difference between the two was more than five-fold. Sensitivity analysis was rarely affected by changes in the cost of medical treatment and the prevalence rate, but the effectiveness rate could be fairly affected by the consultation rate for closer examination.


CONCLUSIONS
Mass screening for cervical cancer is acceptable in terms of economic effectiveness. Moreover, mass screening for cervical cancer could decrease the morbidity rate for scores of years thereafter.
Sato
S
S
Department of Obstetrics and Gynecology, Tohoku University School of Medicine, Sendai, Japan.
Matunaga
G
G
Tsuji
I
I
Yajima
A
A
Sasaki
H
H
D000328:Adult; D000368:Aged; D003198:Computer Simulation; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D015995:Prevalence; D012680:Sensitivity and Specificity; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000191:economics / Q000453:epidemiology