Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy.
BACKGROUND
We estimated the number of women undergoing cervical cancer screening annually in Italy, the rates of cervical abnormalities detected, and the costs of screening and management of abnormalities.


METHODS
The annual number of screened women was estimated from National Health Interview data. Data from the Italian Group for Cervical Cancer Screening were used to estimate the number of positive, negative and unsatisfactory Pap smears. The incidence of CIN (cervical intra-epithelial neoplasia) was estimated from the Emilia Romagna Cancer Registry. Patterns of follow-up and treatment costs were estimated using a typical disease management approach based on national guidelines and data from the Italian Group for Cervical Cancer Screening. Treatment unit costs were obtained from Italian National Health Service and Hospital Information System of the Lazio Region.


RESULTS
An estimated 6.4 million women aged 25-69 years undergo screening annually in Italy (1.2 million and 5.2 million through organized and opportunistic screening programs, respectively). Approximately 2.4% of tests have positive findings. There are approximately 21,000 cases of CIN1 and 7,000-17,000 cases of CIN2/3. Estimated costs to the healthcare service amount to 158.5 million euro for screening and 22.9 million euro for the management of cervical abnormalities.


CONCLUSIONS
Although some cervical abnormalities might have been underestimated, the total annual cost of cervical cancer prevention in Italy is approximately 181.5 million euro, of which 87% is attributable to screening.
Giorgi Rossi
Paolo
P
Agency for Public Health, Lazio Region, Rome, Italy. giorgirossi@asplazio.it
Ricciardi
Alessandro
A
Cohet
Catherine
C
Palazzo
Fabio
F
Furnari
Giacomo
G
Valle
Sabrina
S
Largeron
Nathalie
N
Federici
Antonio
A
D000328:Adult; D017677:Age Distribution; D000368:Aged; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer; D005260:Female; D017048:Health Care Costs; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008403:Mass Screening / Q000191:economics*; D008875:Middle Aged; D065006:Papanicolaou Test; D012042:Registries; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D002578:Uterine Cervical Dysplasia / Q000191:economics / Q000453:epidemiology* / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000453:epidemiology* / Q000473:pathology; D014626:Vaginal Smears