[Cost-effectiveness of a cervical cancer screening programme in the Algarve region, Portugal].
BACKGROUND
Economic evaluation of health care is an instrument of support to decision-making in the allocation of resources between different options. The current study was conducted with a view to implement an organised mass-screening programme. The objective was to evaluate the cost-effectiveness of three options: two programmes to be implemented that are called "Pap screenings" and "Thin-prep screening", and the strategy currently in place called "Spontaneous screening".


METHODS
The analysis was undertaken from the Health Care System perspective. The analytic horizon was 10 years. Direct medical costs were estimated and discounted at a rate of 5%. Effectiveness was estimated as number of preinvasive carcinomas detected and life years gained. The cost-effectiveness ratio was estimated for the three options and incremental cost-effectiveness was estimated by comparison of the options to be implemented with the current strategy. A sensitivity analysis was conducted on the key variables.


RESULTS
The average cost per carcinoma detected was 1,199 euros with "Pap screening", 3,148 euros with "spontaneous screening" and 4,619 euros with "Thin-prep screening". The average cost per life year gained was 29 euros with "Pap screening", 77 euros with "Spontaneous screening" and 114 euros with "Thin-prep screening". "Pap screening" had an additional cost of 623 euros per additional carcinoma detected and 15 euros per additional life year gained. "Thin-prep screening" had an additional cost of 6,350 euros per additional carcinoma detected and 156 euros per additional life year gained.


CONCLUSIONS
"Pap screening" had the best cost-effectiveness relation and the lowest additional cost-effectiveness.
Novoa Vázquez
Rosa María
RM
Centro Regional de Saúde Pública, Administración Regional de Saúde del Algarve, Faro, Portugal. rosamarianovoa@yahoo.es
D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics*; D011174:Portugal; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000191:economics* / Q000517:prevention & control; D014626:Vaginal Smears / Q000191:economics*