title: Annual national direct and indirect cost estimates of the prevention and treatment of cervical cancer in Brazil.
abstract: OBJECTIVE
  To estimate the annual direct and indirect costs of the prevention and treatment of cervical cancer in Brazil.
  
  
  METHODS
  This cost description study used a "gross-costing" methodology and adopted the health system and societal perspectives. The estimates were grouped into sets of procedures performed in phases of cervical cancer care: the screening, diagnosis and treatment of precancerous lesions and the treatment of cervical cancer. The costs were estimated for the public and private health systems, using data from national health information systems, population surveys, and literature reviews. The cost estimates are presented in 2006 USD.
  
  
  RESULTS
  From the societal perspective, the estimated total costs of the prevention and treatment of cervical cancer amounted to USD $1,321,683,034, which was categorized as follows: procedures (USD $213,199,490), visits (USD $325,509,842), transportation (USD $106,521,537) and productivity losses (USD $676,452,166). Indirect costs represented 51% of the total costs, followed by direct medical costs (visits and procedures) at 41% and direct non-medical costs (transportation) at 8%. The public system represented 46% of the total costs, and the private system represented 54%.
  
  
  CONCLUSIONS
  Our national cost estimates of cervical cancer prevention and treatment, indicating the economic importance of cervical cancer screening and care, will be useful in monitoring the effect of the HPV vaccine introduction and are of interest in research and health care management.
authors.affiliation: Faculdade de Medicina, Department of Preventive Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Hillegonda Maria Dutilh
authors.initials: HM
authors.lastname: Novaes
authors.affiliation: Department of Public Health, Instituto de Patologia Tropical e Saúde Pública, Universidade Federal de Goiás, Goiânia, GO, Brazil.
authors.forename: Alexander
authors.initials: A
authors.lastname: Itria
authors.affiliation: Instituto de Medicina Social, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, RJ, Brazil.
authors.forename: Gulnar Azevedo e
authors.initials: GA
authors.lastname: Silva
authors.affiliation: Department of Infectious and Parasitic Diseases, Hospital das Clínicas da Faculdade de Medicina, Universidade de São Paulo, São Paulo/SP, Brazil.
authors.forename: Ana Marli Christovam
authors.initials: AM
authors.lastname: Sartori
authors.affiliation: Hospital e Maternidade Leonor Mendes de Barros, Secretaria do Estado da Saúde, São Paulo, SP, Brazil.
authors.forename: Cristina Helena
authors.initials: CH
authors.lastname: Rama
authors.affiliation: Faculdade de Medicina, Department of Preventive Medicine, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Patrícia Coelho de
authors.initials: PC
authors.lastname: Soárez
mesh_terms: D001938:Brazil; D005260:Female; D017048:Health Care Costs / Q000706:statistics & numerical data; D005102:Health Expenditures / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000191:economics; D009313:National Health Programs / Q000191:economics; D053918:Papillomavirus Vaccines / Q000191:economics; D017149:Private Sector / Q000191:economics*; D017150:Public Sector / Q000191:economics*; D002583:Uterine Cervical Neoplasms / Q000191:economics* / Q000628:therapy*
chemical_list: D053918:Papillomavirus Vaccines