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首页> 外文期刊>Preventive Medicine: An International Journal Devoted to Practice and Theory >The cost-effectiveness of human papillomavirus self-collection among cervical cancer screening non-attenders in El Salvador
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The cost-effectiveness of human papillomavirus self-collection among cervical cancer screening non-attenders in El Salvador

机译：宫颈癌中人乳头瘤病毒自集的成本效益萨尔瓦多非参加者

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Cervical cancer screening with human papillomavirus (HPV) DNA testing has been incorporated into El Salvador's national guidelines. The feasibility of home-based HPV self-collection among women who do not attend screening at the clinic (i.e., non-attenders) has been demonstrated, but cost-effectiveness has not been evaluated. Using cost and compliance data from El Salvador, we informed a mathematical microsimulation model of HPV infection and cervical carcinogenesis to conduct a cost-effectiveness analysis from the societal perspective. We estimated the reduction in cervical cancer risk, lifetime cost per woman (2017 US$), life expectancy, and incremental cost-effectiveness ratio (ICER, 2017 US$ per year of life saved [YLS]) of a program with home-based self-collection of HPV (facilitated by health promoters) for the 18% of women reluctant to screen at the clinic. The model was calibrated to epidemiologic data from El Salvador. We evaluated health and economic outcomes of the self-collection intervention for women aged 30 to 59 years, alone and in concert with clinic-based HPV provider-collection. Home-based self-collection of HPV was projected to reduce population cervical cancer risk by 14% and cost $1210 per YLS compared to no screening. An integrated program reaching 99% coverage with both provider- and home-based self-collection of HPV reduced cancer risk by 74% (compared to no screening), and cost $1210 per YLS compared to provider-collection alone. Self-collection facilitated by health promoters is a cost-effective strategy for increasing screening uptake in El Salvador.
机译：用人乳头瘤病毒（HPV）DNA测试的宫颈癌筛选已纳入El Salvador的国家指导方针。已经证明不参加诊所（即非参加者）筛选的家庭HPV自集的可行性，但尚未评估成本效益。利用来自萨尔瓦多的成本和合规数据，我们通知了HPV感染和宫颈癌的数学微疗模型，从社会角度进行了成本效益分析。我们估计宫颈癌风险，每名女性的终身成本（2017美元），预期寿命和增量成本效益比（ICER，2017美元，每年寿命持续的效率[YLS]） HPV（由健康启动子促进）的自我收集，为18％的女性在诊所筛选。该模型从El Salvador校准到流行病学数据。我们评估了30至59岁的妇女自收集干预的健康和经济结果，单独和与基于诊所的HPV提供商集合的音乐会。预计家庭自集的HPV将减少14％的人口宫颈癌风险，而且与没有筛选相比，每YLS的每月1210美元。综合计划覆盖了99％的覆盖范围，提供了提供者和家庭的自我收集的HPV，将癌症风险降低74％（与无筛选相比），与单独的提供商集合相比，每YLS为1210美元。健康启动子的自我收集是一种成本效益，即增加萨尔瓦多筛选的筛选策略。

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