title: Estimation of savings of life-years and cost from early detection of cervical cancer: a follow-up study using nationwide databases for the period 2002-2009.
abstract: BACKGROUND
  Few studies consider both the survival and financial benefits of detection of invasive cervical cancer (ICC) at earlier stages. This study estimated the savings in life-years and costs from early diagnosis of cervical cancer using an ex post approach.
  
  
  METHODS
  A total of 28,797 patients diagnosed with cervical cancer in the period 2002-2009 were identified from the National Cancer Registry of Taiwan, and linked to the National Mortality Registry until the end of 2011. Life expectancies (LE) for cancer at different stages were estimated using a semi-parametric extrapolation method. The expected years of life lost (EYLL) for cancer were calculated by subtracting the LE of the cancer cohort from that of the age-and sex-matched general population. The mean lifetime costs after diagnosis paid by the single-payer National Health Insurance during (NHI) 2002-2010 were estimated by multiplying average monthly expenditures by the survival probabilities and summing up over lifetime.
  
  
  RESULTS
  ICC at stages 1 to 4 had an average EYLL of 6.33 years, 11.64 years, 12.65 years, and 18.61 years, respectively, while the related lifetime costs paid by the NHI were $7,020, $10,133, $11,120, and $10,015 US dollars, respectively; the younger the diagnosis age, the higher the savings with regard to EYLL. The mean lifetime costs of managing cervical cancer were generally lower for the earlier stages compared with stages 3 and 4.
  
  
  CONCLUSIONS
  Early detection of ICC saves lives and reduces healthcare costs. These health benefits and monetary savings can be used for cost-effectiveness assessments and the promotion of regular proactive screening, especially among older women.
authors.forename: Mei-Chuan
authors.initials: MC
authors.lastname: Hung
authors.forename: Meng-Ting
authors.initials: MT
authors.lastname: Liu
authors.affiliation: Department of Public Health, National Cheng Kung University College of Medicine, No,1, University Road, Tainan, Taiwan. chengym@mail.ncku.edu.tw.
authors.forename: Ya-Min
authors.initials: YM
authors.lastname: Cheng
authors.forename: Jung-Der
authors.initials: JD
authors.lastname: Wang
mesh_terms: D000368:Aged; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D012042:Registries; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000473:pathology