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Instituto Nacional de Salud Pública

2014, Number 5

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salud publica mex 2014; 56 (5)

Cost analysis of different cervical cancer screening strategies in Mexico

Beal CM, Salmerón J, Flores YN, Torres L, Granados-García V, Dugan E, Lazcano-Ponce E

Language: Spanish
References: 34
Page: 492-501
PDF size: 337.54 Kb.


ABSTRACT

Objective. To compare the costs and number of undetected cases of four cervical cancer screening strategies (CCSS) in Mexico. Materials and methods. We estimated the costs and outcomes of the following CCSS: a) conventional Papanicolaou smear (Pap) alone; b) high-risk human papilloma virus testing (HR-HPV) as primary screening with Pap as reflex triage; c) HR-HPV as primary screening with HPV-16/18 typing, liquid-based cytology (LBC) and immunostaining for p16/Ki67 testing as reflex triage, and d) co-testing with HR-HPV and LBC with HPV-16/18 typing and immunostaining for p16/Ki67 as reflex triage. The outcome of interest was high-grade cervical lesions or cervical cancer. Results. HR-HPV testing, HPV typing, LBC testing and immunostaining is the best alternative because it is the least expensive option with an acceptable number of missed cases. Conclusions. The opportunity costs of a poor quality CCSS is many false negatives. Combining multiple tests may be a more cost-effective way to screen for cervical cancer in Mexico.


REFERENCES

  1. Program for Appropriate Technology in Health. National history of cervical cancer: even infrequent screening of older women saves lives. Cervical Cancer Prevention Fact Sheet [internet series]. Seattle: Path, 2000. [Accessed September 17, 2014]. Available at: http://www.path.org/ publications/files/RH_natural_history_of_cc_fs.pdf

  2. Palacio-Mejía LS, Lazcano-Ponce E, Allen-Leigh B, Hernández-Ávila M. Regional differences in breast and cervical cancer mortality in Mexico between 1979-2006. Salud Publica Mex 2009;51(2):S208-S219.

  3. Hernández-ávila M, Lazcano-Ponce EC, Alonso-de Ruiz P, Romieu I. Evaluation of the cervical cancer screening program in Mexico: a population-based case-control study. Int J Epidemiol 1998;27:1-7.

  4. Lazcano-Ponce EC, Rascón-Pacheco RA, Lozano-Ascencio R, Velasco- Mondragón HE. Mortality from cervical carcinoma in Mexico: impact of screening, 1980-1990. Acta Cytol 1996;40:506-512.

  5. America Society of Clinical Oncology. Cervical cancer screening with vinegar could prevent thousands of death each year in developing countries [internet series]. 2013. [Accessed September 17, 2014]. Available at: http://www.cancer.net/research-and-advocacy/research-summaries/ cervical-cancer-screening-vinegar-could-prevent-thousands-deaths-eachyear- developing-countries

  6. Gravitt P, Coutlee F, Iftner T, Sellors J, Quint W, Wheeler C. New technologies in cervical cancer screening. Vaccine 2008;26S:K42-K52.

  7. Placide J, Martens MG. Comparing screening methods for osteoporosis. Curr Womens Health Rep 2003;3(3):207-210.

  8. Waxman A. Guidelines for cervical cancer screening: history and scientific rationale. Clin Obstet Gynecol 2005;48(1):77-97.

  9. Yeoh G, Tse M, Chan K, Lord L. Human papillomavirus DNA and liquid-based cervical cytology cotesting in screening and follow-up patient groups. Acta Cytol 2006;50(6):627-631.

  10. Huchko M, Sneden J, Leslie H, Abdulrahim N, Maloba M, Bukusi E, Cohen C. A comparison of two visual inspection methods for cervical cancer screening among HIV-infected women in Kenya. Bull World Health Organ 2014;92(3):195-203.

  11. Flores Y, Shah K, Lazcano E, Hernández M, Bishai D, Ferris D, et al. Design and methods of the evaluation of an HPV-based cervical cancer screening strategy in Mexico: The Morelos HPV Study. Salud Publica Mex 2002;44(4):335-344.

  12. Bosch F, Qiao Y, Castellsagué X. The epidemiology of human papillomavirus infection and its association with cervical cancer. Int J Gynaecol Obstet 2006;94:S8-S21.

  13. Luu H, Dahlstrom K, Mullen P, VonVille H, Scheurer M. Comparison of the accuracy of Hybrid Capture II and polymerase chain reaction in detecting clinically important cervical dysplasia: a systematic review and meta-analysis. Cancer Med 2013;l 2(3):367-390.

  14. Ronco G, Giorgi-Rossi P, Carozzi F, Confortini M, Palma P, Mistro A, et al. Results at recruitment from a randomized controlled trial comparing human papillomavirus testing alone with conventional cytology as the primary cervical cancer screening test. J Natl Cancer Inst 2008;100(7):492-501.

  15. Schiffman M, Herrero R, Hildesheim A, Sherman M, Bratti M, Wacholder S, et al. HPV DNA testing in cervical cancer screening results from women in a high-risk province in Costa Rica. JAMA 2000;283(1):87-93.

  16. Cuzick J, Mayrand M, Ronco G, Snijders P, Wardle J. Chapter 10: New dimensions in cervical cancer screening. Vaccine 2006;24 suppl 3:S3/S90-S97.

  17. Arbyn M, Sasieni P, Meijer C, Clavel C, Koliopoulos G, Dillner J. Chapter 9: Clinical applications of HPV testing: A summary of metaanalyses. Vaccine 2006;24 suppl 3:S3/S78-S89.

  18. Flores Y, Bishai D, Lörincz A, Shah K, Lazcano-Ponce E, Hernández M, et al. HPV testing for cervical cancer screening appears more costeffective than Papanicolau cytology in Mexico. Cancer Causes Control 2011;22(2):261-272

  19. Instituto Nacional de Estadística y Geografía. Population: distribution by age and sex [internet series]. México: Inegi, 2010. [Accessed September 17, 2014]. Available at: http://www3.inegi.org.mx/Sistemas/temas/Default. aspx?s=est&c=17484

  20. Salmerón J, Lazcano-Ponce E, Lorincz A, Hernández M, Hernández P, Leyva A, et al. Comparison of HPV-based assays with Papanicolaou smears for cervical cancer screening in Morelos State, Mexico. Cancer Causes Control 2003;14(6):505-512.

  21. Cuzick J, Clavel C, Petry K, Meijer C, Hoyer H, Ratnum S, et al. Overview of the European and North American studies on HPV testing in primary cervical cancer screening. Int J Cancer 2006;119:1095-1101.

  22. Mayrand M, Duarte-Franco E, Rodrigues I, Walter S, Hanley J, Ferenczy A, et al. Human papullomavirus DNA versus Papanicolaou screening tests for cervical cancer. N Engl J Med 2007;357(16):1579-1588.

  23. Einstein M, Martens M, Garcia F, Ferris D, Mitchell A, Day S, Olson M. Clinical validation of the Cervista HOV HR and 16/18 genotyping tests for use in women with ASC-US cytology. Gynecol Oncol 2010;118:116-122.

  24. Zappacosta R, Colasante A, Viola P, D’Antuono T, Lattanzio G, Capanna S, et al. Chromogenic in situ hybridization and p16/Ki67 dual staining on formalin-fixed paraffin-embedded cervical specimens: correlation with HPV-DNA test, E6/E7 mRNA test, and potential clinical applications. Biomed Res Int 2013;2013: 453606.

  25. Insinga RP, Dasbach EJ, Elbasha EH, Puig A, Reynales-Shigematsu LM. Cost-effectiveness of quadrivalent human papillomavirus (HPV) vaccination in Mexico: a transmission dynamic model-based evaluation. Vaccine 2007;26(1):128-39.

  26. Moyer VA, US Preventive Services Task Force. Screening for Cervical Cancer: U.S. Preventive Services Task Force recommendation statement [internet series]. Ann Intern Med 2012;156(12):880-891. [Accessed September 17, 2014]. Available at: http://www.uspreventiveservicestaskforce. org/uspstf11/cervcancer/cervcancerrs.pdf

  27. Bernal-Silva S, Granados J, Gorodezky C, Aláez C, Flores-Aguilar H, Cerda-Flores RM, et al. HLA-DRB1 Class II antigen level alleles are associated with persistent HPV infection in Mexican women; a pilot study. Infect Agent Cancer 2013;8(1):31.

  28. Bian M, Cheng J, Ma L, Cong X, Liu J, Chen Y, Chen X. Evaluation of the detection of 14 high-risk human papillomaviruses with HPV 16 and HPV 18 genotyping for cervical cancer screening. Exp Ther Med 2013;6(5):1332-1336.

  29. Lazcano-Ponce E, Lörinz A, Salmerón J, Fernández I, Cruz A, Hernández P, et al. A pilot study of HPV DNA and cytology testing in 50 159 women in the routine Mexican Social Security Program. Cancer Causes Control 2010;21:1693-1700.

  30. Duggan M, Brasher P. Accuracy of Pap test reported as CIN I. Diagn Cytopathol 1999;21(2):129-136.

  31. Spitzer M, Apgar B, Brotzman G. Management of histologic abnormalities of the cervix. Am Fam Physician 2006;73(1):105-112.

  32. Denny L, Kuhn L, Pollack A, Wainwright H, Wright T. Evaluation of alternative methods of cervical cancer screening for resources-poor settings. Cancer 2000;89(4):826-833.

  33. Koliopoulos G, Arbyn M, Martin-Hirsch P, Kyrgiou M, Prendiville W, Paraskevaidis E. Diagnostic accuracy of human papillomavirus testing in primary cervical screening: a systematic review and meta-analysis of nonrandomized studies. Gynecol Oncol 2007;104:232-246.

  34. Cuzick J, Arbyn M, Sankaranarayanan R, Tsu V, Ronco G, Mayrand M, et al. Overview of human pappillomavirus-based and other novel options for cervical cancer screening in developed and developing countries. Vaccine 2008;19:26 suppl 10:K29-K41.




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