TY - JOUR
T1 - Cost-effectiveness of strategies to increase screening coverage for cervical cancer in Spain: the CRIVERVA study
AU - Trapero-Bertran, Marta
AU - Acera Pérez, Amelia
AU - De Sanjosé, Silvia
AU - Manresa Domínguez, Josep Maria
AU - Rodríguez Capriles, Diego
AU - Rodriguez Martinez, Ana
AU - Bonet Simó, Josep Maria
AU - Sanchez Sanchez, Norman
AU - Hidalgo Valls, Pablo
AU - Díaz Sanchis, Mireia
PY - 2017/2/14
Y1 - 2017/2/14
N2 - © 2017 The Author(s). Background: The aim of the study is to carry out a cost-effectiveness analysis of three different interventions to promote the uptake of screening for cervical cancer in general practice in the county of Valles Occidental, Barcelona, Spain. Methods: Women aged from 30 to 70 years (n = 15,965) were asked to attend a general practice to be screened. They were randomly allocated to one of four groups: no intervention group (NIG); one group where women received an invitation letter to participate in the screening (IG1); one group where women received an invitation letter and informative leaflet (IG2); and one group where women received an invitation letter, an informative leaflet and a phone call reminder (IG3). Clinical effectiveness was measured as the percentage increase in screening coverage. A cost-effectiveness analysis was performed from the perspective of the public health system with a time horizon of three to five years - the duration of the randomised controlled clinical trial. In addition, a deterministic sensitivity analysis was performed. Results are presented according to different age groups. Results: The incremental cost-effectiveness ratio (ICER) for the most cost-effective intervention, IG1, compared with opportunistic screening was € 2.78 per 1% increase in the screening coverage. The age interval with the worst results in terms of efficiency was women aged < 40 years. Conclusions: In a population like Catalonia, with around 2 million women aged 30 to 70 years and assuming that 40% of these women were not attending general practice to be screened for cervical cancer, the implementation of an intervention to increase screening coverage which consists of sending a letter would cost on average less than € 490 for every 1000 women. Trial registration: ClinicalTrials.gov Identifier: NCT01373723 .
AB - © 2017 The Author(s). Background: The aim of the study is to carry out a cost-effectiveness analysis of three different interventions to promote the uptake of screening for cervical cancer in general practice in the county of Valles Occidental, Barcelona, Spain. Methods: Women aged from 30 to 70 years (n = 15,965) were asked to attend a general practice to be screened. They were randomly allocated to one of four groups: no intervention group (NIG); one group where women received an invitation letter to participate in the screening (IG1); one group where women received an invitation letter and informative leaflet (IG2); and one group where women received an invitation letter, an informative leaflet and a phone call reminder (IG3). Clinical effectiveness was measured as the percentage increase in screening coverage. A cost-effectiveness analysis was performed from the perspective of the public health system with a time horizon of three to five years - the duration of the randomised controlled clinical trial. In addition, a deterministic sensitivity analysis was performed. Results are presented according to different age groups. Results: The incremental cost-effectiveness ratio (ICER) for the most cost-effective intervention, IG1, compared with opportunistic screening was € 2.78 per 1% increase in the screening coverage. The age interval with the worst results in terms of efficiency was women aged < 40 years. Conclusions: In a population like Catalonia, with around 2 million women aged 30 to 70 years and assuming that 40% of these women were not attending general practice to be screened for cervical cancer, the implementation of an intervention to increase screening coverage which consists of sending a letter would cost on average less than € 490 for every 1000 women. Trial registration: ClinicalTrials.gov Identifier: NCT01373723 .
KW - Cervical cancer
KW - Cost-effectiveness
KW - Increase coverage
KW - Population screening
U2 - 10.1186/s12889-017-4115-0
DO - 10.1186/s12889-017-4115-0
M3 - Article
SN - 1472-698X
VL - 17
JO - BMC Public Health
JF - BMC Public Health
IS - 1
M1 - 194
ER -