title: Cost of the Cervical Cancer Screening Program at the Mexican Social Security Institute.
abstract: OBJECTIVE
  To estimate the annual cost of the National Cervical Cancer Screening Program (CCSP) of the Mexican Institute of Social Security (IMSS).
  
  
  METHODS
  This cost analysis examined regional coverage rates reported by IMSS. We estimated the number of cytology, colposcopy, biopsy and pathology evaluations, as well as the diagnostic test and treatment costs for cervical intraepithelial neoplasia grade II and III (CIN 2/3) and cervical cancer. Diagnostic test costs were estimated using a micro-costing technique. Sensitivity analyses were performed.
  
  
  RESULTS
  The cost to perform 2.7 million cytology tests was nearly 38 million dollars, which represents 26.1% of the total program cost (145.4 million). False negatives account for nearly 43% of the program costs.
  
  
  CONCLUSIONS
  The low sensitivity of the cytology test generates high rates of false negatives, which results in high institutional costs from the treatment of undetected cervical cancer cases.
authors.affiliation: Unidad de Investigación Epidemiológica y en Sistemas de Salud, Área de envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, Distrito Federal, México.
authors.forename: Víctor
authors.initials: V
authors.lastname: Granados-García
authors.affiliation: Unidad de Investigación Epidemiológica y en Sistemas de Salud, Área de envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, Distrito Federal, México.
authors.forename: Yvonne N
authors.initials: YN
authors.lastname: Flores
authors.affiliation: Coordinación Delegacional de Abastecimiento y Equipamiento, Delegación Morelos, Instituto Mexicano del Seguro Social, México, Distrito Federal, México.
authors.forename: Ruth
authors.initials: R
authors.lastname: Pérez
authors.affiliation: Unidad de Investigación Epidemiológica y en Sistemas de Salud, Área de envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, Distrito Federal, México.
authors.forename: Samantha E
authors.initials: SE
authors.lastname: Rudolph
authors.affiliation: Centro de Investigación en Salud Poblacional, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, México.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Lazcano-Ponce
authors.affiliation: Unidad de Investigación Epidemiológica y en Sistemas de Salud, Área de envejecimiento, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social, México, Distrito Federal, México.
authors.forename: Jorge
authors.initials: J
authors.lastname: Salmerón
mesh_terms: D000047:Academies and Institutes / Q000191:economics*; D000328:Adult; D001706:Biopsy / Q000191:economics / Q000706:statistics & numerical data; D003127:Colposcopy / Q000191:economics / Q000706:statistics & numerical data; D003365:Costs and Cost Analysis; D055088:Early Detection of Cancer / Q000191:economics*; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D065006:Papanicolaou Test / Q000191:economics / Q000706:statistics & numerical data; D012680:Sensitivity and Specificity; D012943:Social Security / Q000191:economics*; D002583:Uterine Cervical Neoplasms / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control*; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology / Q000628:therapy