Evaluation of primary HPV-DNA testing in relation to visual inspection methods for cervical cancer screening in rural China: an epidemiologic and cost-effectiveness modelling study
| العنوان: | Evaluation of primary HPV-DNA testing in relation to visual inspection methods for cervical cancer screening in rural China: an epidemiologic and cost-effectiveness modelling study |
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| المؤلفون: | Jufang Shi, Rosa Legood, Xiang-Xian Feng, Yoon-Jung Kang, Yan Ning, Karen Canfell, Li Ma, Yong-Zhen Zhang, Megan Smith, Jie-Bin Lew, Fang-Hui Zhao, Jun-Feng Chen, Leonardo Simonella, You-Lin Qiao |
| المصدر: | BMC Cancer, Vol 11, Iss 1, p 239 (2011) BMC Cancer |
| بيانات النشر: | Springer Science and Business Media LLC, 2011. |
| سنة النشر: | 2011 |
| مصطلحات موضوعية: | Cancer Research, medicine.medical_specialty, Cost effectiveness, Uterine Cervical Neoplasms, Physical examination, Cervical intraepithelial neoplasia, lcsh:RC254-282, High-Throughput Screening Assays, Genetics, medicine, Humans, Mass Screening, DNA Probes, HPV, Coloring Agents, Physical Examination, Early Detection of Cancer, Mass screening, Acetic Acid, Cervical cancer, Gynecology, medicine.diagnostic_test, business.industry, Obstetrics, Papillomavirus Infections, Health Care Costs, Uterine Cervical Dysplasia, lcsh:Neoplasms. Tumors. Oncology. Including cancer and carcinogens, medicine.disease, Visual inspection, Oncology, DNA, Viral, High Grade Cervical Intraepithelial Neoplasia, Female, business, Research Article |
| الوصف: | Background A new lower-cost rapid-throughput human papillomavirus (HPV) test (careHPV, Qiagen, Gaithersburg, USA) has been shown to have high sensitivity for the detection of high grade cervical intraepithelial neoplasia. Methods We assessed the outcomes and cost-effectiveness of careHPV screening in rural China, compared to visual inspection with acetic acid, when used alone (VIA) or in combination with Lugol's iodine (VIA/VILI). Using data on sexual behaviour, test accuracy, diagnostic practices and costs from studies performed in rural China, we estimated the cost-effectiveness ratio (CER) and associated lifetime outcomes for once-lifetime and twice-lifetime screening strategies, and for routine screening at 5-yearly, 10-yearly and IARC-recommended intervals. The optimal age range for once-lifetime screening was also assessed. Results For all strategies, the relative ordering of test technologies in reducing cervical cancer incidence and mortality was VIA (least effective); VIA/VILI; careHPV@1.0 pg/ml and careHPV@0.5 pg/ml (most effective). For once-lifetime strategies, maximum effectiveness was achieved if screening occurred between 35-50 years. Assuming a participation rate of ~70%, once-lifetime screening at age 35 years would reduce cancer mortality by 8% (for VIA) to 12% (for careHPV@0.5) over the long term, with a CER of US$557 (for VIA) to $959 (for careHPV@1.0) per life year saved (LYS) compared to no intervention; referenced to a 2008 GDP per capita in Shanxi Province of $2,975. Correspondingly, regular screening with an age-standardised participation rate of 62% (which has been shown to be achievable in this setting) would reduce cervical cancer mortality by 19-28% (for 10-yearly screening) to 43-54% (using IARC-recommended intervals), with corresponding CERs ranging from $665 (for 10-yearly VIA) to $2,269 (for IARC-recommended intervals using careHPV@1.0) per LYS. Conclusions This modelled analysis suggests that primary careHPV screening compares favourably to visual inspection screening methodologies in rural China, particularly if used as part of a regular screening program. |
| وصف الملف: | application/pdf |
| تدمد: | 1471-2407 |
| الوصول الحر: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::a2bfbc51fc545c1360dba8bb7fe8cf96Test https://doi.org/10.1186/1471-2407-11-239Test |
| حقوق: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....a2bfbc51fc545c1360dba8bb7fe8cf96 |
| قاعدة البيانات: | OpenAIRE |
| تدمد: | 14712407 |
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