Cost effectiveness of human papillomavirus test of cure after treatment for cervical intraepithelial neoplasia in England: economic analysis from NHS Sentinel Sites Study.

Abstract:

OBJECTIVES:To evaluate the cost effectiveness of human papillomavirus testing after treatment for cervical intraepithelial neoplasia (CIN). DESIGN:Economic analysis using a Markov modelling approach to combine cost and epidemiological data from the NHS Sentinel Sites Study with data from previous studies of post-treatment recurrence rates. SETTING:English NHS Cervical Cancer Screening Programme. INTERVENTIONS:Management guidelines after treatment of CIN involving annual cytology follow-up for 10 years, compared with alternative protocols using the human papillomavirus test to reduce the amount of post-treatment surveillance. MAIN OUTCOME MEASURES:Cases of underlying CIN3+ averted at 10 years and costs per 1000 women treated. RESULTS:Model predictions indicated that, at observed levels of compliance with post-treatment recommendations, management with only cytological follow-up would result in 29 residual cases of recurrent CIN3+ by 10 years and would cost £358,222 (€440,426; $574,910) (discounted) per 1000 women treated. Implementation of human papillomavirus test of cure in cytologically negative women according to the sentinel sites protocol would avert an additional 8.4 cases of CIN 3+ and reduce costs by £9388 per 1000 women treated. CONCLUSIONS:Human papillomavirus test of cure would be more effective and would be cost saving compared with cytology only follow-up. The results of this evaluation support the full scale implementation of human papillomavirus test of cure after treatment of CIN within the NHS Cervical Screening Programme.

journal_name

BMJ

authors

Legood R,Smith M,Lew JB,Walker R,Moss S,Kitchener H,Patnick J,Canfell K

doi

10.1136/bmj.e7086

subject

Has Abstract

pub_date

2012-10-31 00:00:00

pages

e7086

eissn

0959-8138

issn

1756-1833

journal_volume

345

pub_type

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