Revista Española de Salud Pública
Print version ISSN 1135-5727
NOVOA VAZQUEZ, Rosa María. Cost-effectiveness of a cervical cancer screening programme in the Algarve region, Portugal. Rev. Esp. Salud Publica [online]. 2004, vol.78, n.3, pp. 341-353. ISSN 1135-5727. http://dx.doi.org/10.1590/S1135-57272004000300004.
Background: Economic evaluation of health care is an instrument of support to decision-making in the allocation of resources between different options. The current study was conducted with a view to implement an organised mass-screening programme. The objective was to evaluate the cost-effectiveness of three options: two programmes to be implemented that are called «Pap screening» and «Thin-prep screening», and the strategy currently in place called «Spontaneous screening». Methods: The analysis was undertaken from the Health Care System perspective. The analytic horizon was 10 years. Direct medical costs were estimated and discounted at a rate of 5 %. Effectiveness was estimated as number of preinvasive carcinomas detected and life years gained. The cost-effectiveness ratio was estimated for the three options and incremental cost-effectiveness was estimated by comparison of the options to be implemented with the current strategy. A sensitivity analysis was conducted on the key variables. Results: The average cost per carcinoma detected was 1,199 euros with «Pap screening», 3,148 euros with «spontaneous screening» and 4,619 euros with «Thin-prep screening». The average cost per life year gained was 29 euros with «Pap screening», 77 euros with «Spontaneous screening» and 114 euros with «Thin-prep screening». «Pap screening» had an additional cost of 623 euros per additional carcinoma detected and 15 euros per additional life year gained. «Thin-prep screening» had an additional cost of 6,350 euros per additional carcinoma detected and 156 euros per additional life year gained. Conclusions: «Pap screening» had the best cost-effectiveness relation and the lowest additional cost-effectiveness.
Keywords : Cervix neoplasms; Program evaluation; Cost-benefit analysis; Resource allocation; Mass screening.