Projected cost‐effectiveness of repeat high‐risk human papillomavirus testing using self‐collected vaginal samples in the Swedish cervical cancer screening program

• DOI: 10.1111/aogs.12143
• Publication Date: 2013-03-27T09:57:18Z
• Authors: Ellinor Östensson; Ann‐Cathrin Hells...; Kristina Hellman; Inger Gustavsson; Ulf Gyllensten; Erik Wilander; Niklas Zethraeus; Sonia Andersson
• Keywords: Adult; Aged, 80 and over; Risk; Sweden; Vaginal Smears; Adolescent; Cost-Benefit Analysis; Papillomavirus Infections; Uterine Cervical Neoplasms; Health Care Costs; Middle Aged; Models, Biological; Markov Chains; Human Papillomavirus DNA Tests; 3. Good health; 03 medical and health sciences; 0302 clinical medicine; DNA, Viral; Humans; Computer Simulation; Female; Early Detection of Cancer; Aged

Abstract Background Human papillomavirus ( HPV ) testing is not currently used in primary cervical cancer screening Sweden, and corresponding cost‐effectiveness unclear. Objective From a societal perspective, to evaluate the of high‐risk HR )‐ using self‐collected vaginal samples. Design A analysis. Setting The Swedish organized program. Methods We constructed model simulate natural history data on risk. For base‐case analysis we evaluated two strategies with different intervals: (i) cytology throughout woman's lifetime (i.e. “conventional strategy”) (ii) conventional until age 35 years, followed by ‐ samples women aged ≥35 years “combination strategy”). Sensitivity analyses were performed, varying parameters over significant range values identify cost‐effective strategies. Main outcome measures Average cost, discounted undiscounted life‐years gained, reduction risk, incremental ratios without cost added life‐years. Results Depending interval, for combination strategy ranged from €43 000 €180 per gained life‐years, €74 €206 costs included. Conclusion 5‐year interval potentially compared no screening, current practice when threshold value €80 gained.