title: Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia.
abstract: OBJECTIVE
  To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia.
  
  
  METHODS
  The National Cancer Institute of Colombia (NCIC) in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effectiveness ratios were estimated and sensitivity analyses were conducted for key parameters.
  
  
  RESULTS
  Depending on the screening strategy a 69-81% mortality reduction might be expected. The HPV DNA testing every five years is a cost-effective strategy (Incremental Cost-Effectiveness Ratio (ICER): USD$44/YLS) if the cost per test is under USD$31. The effectiveness was sensitive to coverage and primarily to follow-up.
  
  
  CONCLUSIONS
  HPV DNA testing is a cost-effective alternative for screening in Colombia. Not only high coverage but high follow-up rates are critical for successful screening programs.
authors.affiliation: Clinical Research Group, National Cancer Institute of Colombia, Bogotá Colombia. ogamboa@cancer.gov.co
authors.forename: Oscar
authors.initials: O
authors.lastname: Andrés-Gamboa
authors.forename: Liliana
authors.initials: L
authors.lastname: Chicaíza
authors.forename: Mario
authors.initials: M
authors.lastname: García-Molina
authors.forename: Jorge
authors.initials: J
authors.lastname: Díaz
authors.forename: Mauricio
authors.initials: M
authors.lastname: González
authors.forename: Raúl
authors.initials: R
authors.lastname: Murillo
authors.forename: Mónica
authors.initials: M
authors.lastname: Ballesteros
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sánchez
mesh_terms: D000328:Adult; D000368:Aged; D003105:Colombia; D003362:Cost-Benefit Analysis; D015344:DNA Probes, HPV / Q000191:economics*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D002583:Uterine Cervical Neoplasms / Q000473:pathology* / Q000821:virology*
chemical_list: D015344:DNA Probes, HPV