title: [Cost-benefit analysis of a population-based cervical cancer screening program designed for Cantabria].
abstract: BACKGROUND
  Cervical cancer is the second most common cancer worldwide in women, with an annual mortality of 3.6 per 100.000 women in Spain. An opportunistic screening protocol is currently being developed in Cantabria. The objective of the study is to propose a population-based screening program in Cantabria and assess its cost-benefits.
  
  
  METHODS
  The population-based program design has been carried out according to the description of the natural course of cervical cancer and its incidence and mortality in Cantabria during 2000-2009. There have been some proposals to increase participation in the program and to evaluate its quality. Costs and benefits (direct and indirect) have been analyzed in several scenarios by modifying the frequency of tests (3-5 years), the age at which the program can be accessed (21, 25 or 30 years), the coverage of the program (60-80%), and discount rates (0-3-6%).
  
  
  RESULTS
  A program carried out with coverage of 80% and tests performed every 3 years generates annual costs of €893.000 (discount rate of 3%) compared to the current opportunistic protocol. Scenarios with tests performed every 5 years generate an annual benefit higher than €618.000, depending on the age of accessing the program.
  
  
  CONCLUSIONS
  Scenarios with coverage lower than 60% or with women over 30 years old having access to the program are not of interest because of the lower health benefits. However, performing tests every 5 years is more economically advantageous than every 3 years, with similar health benefits.
authors.affiliation: Servicio de Urgencias de Atención Primaria de Torrelavega, Gerencia de Atención Primaria, Servicio Cántabro de Salud, Torrelavega, Cantabria, España. Electronic address: angeles.ramosb@gmail.com.
authors.forename: M Á
authors.initials: MÁ
authors.lastname: Ramos-Barrón
authors.affiliation: Servicio de Oncología Radioterápica, Hospital Universitario Marqués de Valdecilla, Servicio Cántabro de Salud, Santander, Cantabria, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Vázquez-Rodríguez
authors.affiliation: Centro de Salud de Suances, Gerencia de Atención Primaria, Servicio Cántabro de Salud, Suances, Cantabria, España.
authors.forename: A B
authors.initials: AB
authors.lastname: García-Garrido
mesh_terms: D000328:Adult; D000367:Age Factors; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D013030:Spain; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D055815:Young Adult
keywords: Análisis coste-beneficio; Cervical cancer; Cost-benefit analysis; Cribado poblacional; Cáncer de cuello uterino; Economic evaluation; Evaluación económica; Oportunista; Opportunistic; Population screening; Programa de cribado; Screening program
vernacular_title: Análisis coste-beneficio de un programa poblacional de diagnóstico precoz de cáncer de cuello uterino diseñado para Cantabria.