Cost-effectiveness of strategies to increase screening coverage for cervical cancer in Spain: the CRIVERVA study

Marta Trapero-Bertran, Amelia Acera Pérez, Silvia De Sanjosé, Josep Maria Manresa Domínguez, Diego Rodríguez Capriles, Ana Rodriguez Martinez, Josep Maria Bonet Simó, Norman Sanchez Sanchez, Pablo Hidalgo Valls, Mireia Díaz Sanchis

Research output: Contribution to journalArticleResearchpeer-review

13 Citations (Scopus)


© 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: Identifier: NCT01373723 .
Original languageEnglish
Article number194
JournalBMC Public Health
Issue number1
Publication statusPublished - 14 Feb 2017


  • Cervical cancer
  • Cost-effectiveness
  • Increase coverage
  • Population screening


Dive into the research topics of 'Cost-effectiveness of strategies to increase screening coverage for cervical cancer in Spain: the CRIVERVA study'. Together they form a unique fingerprint.

Cite this