title: Cancer of the cervix: Early detection and cost-effective solutions.
abstract: Cervical cancer is known to be a preventable disease through the detection of cervical cancer precursors, historically using cytology of the cervix as the primary screening test. Over 85% of cervical cancer cases and deaths occur in low-resource countries. Alternatives to cytology have been investigated with the strongest possibilities being visual inspection with acetic acid (VIA) and HPV DNA testing. HPV DNA testing has been shown in randomized trials to be significantly more sensitive for the detection of cervical cancer precursors than either cytology or VIA. In this paper we argue that prevention really does cost less than cure, or that prevention and treatment of cancer costs less than no prevention, in effect just treatment, of cancer. The true cost savings of prevention will include a more difficult assessment of the socioeconomic savings associated with longer, healthier lives for women in their prime who have a major role in supporting their families.
authors.affiliation: University of Cape Town/Groote Schuur Hospital, Cape Town, South Africa. Electronic address: lynette.denny@uct.ac.za.
authors.forename: Lynette
authors.initials: L
authors.lastname: Denny
authors.affiliation: International Agency for Research on Cancer, 150 Cours Albert Thomas, Lyon, France.
authors.forename: Walter
authors.initials: W
authors.lastname: Prendiville
mesh_terms: D019342:Acetic Acid; D000328:Adult; D000368:Aged; D003362:Cost-Benefit Analysis; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods; D005260:Female; D061809:Human Papillomavirus DNA Tests / Q000191:economics; D006801:Humans; D007202:Indicators and Reagents; D008403:Mass Screening / Q000191:economics* / Q000379:methods; D008875:Middle Aged; D011230:Precancerous Conditions / Q000175:diagnosis*; D055502:Secondary Prevention / Q000191:economics* / Q000379:methods; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control
chemical_list: D007202:Indicators and Reagents; D019342:Acetic Acid
keywords: Cervical cancer; Cost-effectiveness; HPV; HPV DNA testing; Secondary prevention; Visual inspection with acetic acid