Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia.
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.
Andrés-Gamboa
Oscar
O
Clinical Research Group, National Cancer Institute of Colombia, Bogotá Colombia. ogamboa@cancer.gov.co
Chicaíza
Liliana
L
García-Molina
Mario
M
Díaz
Jorge
J
González
Mauricio
M
Murillo
Raúl
R
Ballesteros
Mónica
M
Sánchez
Ricardo
R
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*
D015344:DNA Probes, HPV