Cervical cancer screening with AMIGAS: a cost-effectiveness analysis.
BACKGROUND
Hispanic women have a higher incidence of cervical cancer than all other races and ethnicities. In Hispanic subgroups, Mexican American women were among the least likely to have received cervical cancer screening. In a recent RCT, Ayudando a las Mujeres con Información, Guia, y Amor para su Salud (AMIGAS) was shown to increase cervical cancer screening rates among women of Mexican descent at 6 months in all intervention arms compared to the control arm. Limited information exists about the economics of interventions to increase cervical cancer screening rates among women of Mexican descent.


OBJECTIVE
This study aims to estimate the cost-effectiveness of the alternative AMIGAS intervention methods for increasing cervical cancer screening among low-income women of Mexican descent in three U.S. communities.


METHODS
Cost data were collected from 2008 to 2011 alongside the AMIGAS study of 613 women. Receipt of Pap test within 6 months of intervention was the primary outcome measure in the cost-effectiveness analysis, conducted during 2012-2013.


RESULTS
The cost per additional woman screened comparing the video-only intervention to usual care was $980. The cost increased to $1,309 with participant time cost included. With an additional cost per participant of $3.90 compared to flipchart only, the full AMIGAS program (video plus flipchart) yielded 6.8% additional women screened.


CONCLUSIONS
Results on the average and incremental cost-effectiveness of the AMIGAS program elements may assist health policymakers and program managers to select and appropriately budget for interventions shown to increase cervical cancer screening among low-income women of Mexican descent.
School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas. Electronic address: david.r.lairson@uth.tmc.edu.
David R
DR
Lairson
School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas.
Yu-Chia
YC
Chang
Paul L. Foster School of Medicine, Texas Tech University, Lubbock, Texas.
Theresa L
TL
Byrd
CDC, Division of Cancer Prevention and Control, Atlanta, Georgia.
Judith
J
Lee Smith
School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas; Center for Health Promotion and Prevention Research, University of Texas Health Science Center at Houston, Houston, Texas.
Maria E
ME
Fernandez
Epidemiology and Analysis Program Office, Atlanta, Georgia.
Katherine M
KM
Wilson
D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000191:economics / Q000379:methods*; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D065006:Papanicolaou Test / Q000191:economics / Q000706:statistics & numerical data; D011203:Poverty; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000191:economics; D014626:Vaginal Smears / Q000191:economics / Q000706:statistics & numerical data*; D055815:Young Adult