Cost effectiveness of human papillomavirus test of cure after treatment for cervical intraepithelial neoplasia in England: economic analysis from NHS Sentinel Sites Study
Field | Value | Language |
dc.contributor.author | Legood R | en_AU |
dc.contributor.author | Smith MA | en_AU |
dc.contributor.author | Lew JB | en_AU |
dc.contributor.author | Walker R | en_AU |
dc.contributor.author | Moss S | en_AU |
dc.contributor.author | Kitchener H | en_AU |
dc.contributor.author | Patnick J | en_AU |
dc.contributor.author | Canfell K | en_AU |
dc.date.issued | 2012 | |
dc.date.issued | 2012 | en |
dc.identifier.uri | https://hdl.handle.net/2123/30927 | |
dc.description.abstract | OBJECTIVES: To evaluate the cost effectiveness of human papillomavirus testing after treatment for cervical intraepithelial neoplasia (CIN). DESIGN: Economic analysis using a Markov modelling approach to combine cost and epidemiological data from the NHS Sentinel Sites Study with data from previous studies of post-treatment recurrence rates. SETTING: English NHS Cervical Cancer Screening Programme. INTERVENTIONS: Management guidelines after treatment of CIN involving annual cytology follow-up for 10 years, compared with alternative protocols using the human papillomavirus test to reduce the amount of post-treatment surveillance. MAIN OUTCOME MEASURES: Cases of underlying CIN3+ averted at 10 years and costs per 1000 women treated. RESULTS: Model predictions indicated that, at observed levels of compliance with post-treatment recommendations, management with only cytological follow-up would result in 29 residual cases of recurrent CIN3+ by 10 years and would cost pound358,222 (euro440,426; $574,910) (discounted) per 1000 women treated. Implementation of human papillomavirus test of cure in cytologically negative women according to the sentinel sites protocol would avert an additional 8.4 cases of CIN 3+ and reduce costs by pound9388 per 1000 women treated. CONCLUSIONS: Human papillomavirus test of cure would be more effective and would be cost saving compared with cytology only follow-up. The results of this evaluation support the full scale implementation of human papillomavirus test of cure after treatment of CIN within the NHS Cervical Screening Programme | en_AU |
dc.publisher | BMJ | en_AU |
dc.subject | analysis | en_AU |
dc.subject | Early Detection of Cancer | en_AU |
dc.subject | economics | en_AU |
dc.subject | Guidelines | en_AU |
dc.subject | Health Services | en_AU |
dc.subject | Health Services Research | en_AU |
dc.subject | Humans | en_AU |
dc.subject | Markov Chains | en_AU |
dc.subject | Mass Screening | en_AU |
dc.subject | cancer | en_AU |
dc.subject | Middle Aged | en_AU |
dc.subject | Models,Theoretical | en_AU |
dc.subject | Neoplasm Recurrence,Local | en_AU |
dc.subject | Papillomavirus Infections | en_AU |
dc.subject | Patient Compliance | en_AU |
dc.subject | screening | en_AU |
dc.subject | Sentinel Surveillance | en_AU |
dc.subject | therapy | en_AU |
dc.subject | Treatment Outcome | en_AU |
dc.subject | Uterine Cervical Neoplasms | en_AU |
dc.subject | virology | en_AU |
dc.subject | Cervical Intraepithelial Neoplasia | en_AU |
dc.subject | Cost-Benefit Analysis | en_AU |
dc.subject | diagnosis | en_AU |
dc.subject | drug therapy | en_AU |
dc.subject.other | Cancer Type - Cervical Cancer | en_AU |
dc.subject.other | Cancer Control, Survivorship, and Outcomes Research - Health Services, Economic and Health Policy Analyses | en_AU |
dc.title | Cost effectiveness of human papillomavirus test of cure after treatment for cervical intraepithelial neoplasia in England: economic analysis from NHS Sentinel Sites Study | en_AU |
dc.type | Article | en_AU |
dc.identifier.doi | 10.1136/bmj.e7086 | |
dc.relation.other | The study was funded by the NHS Cancer Screening Programme. KC was supported by a NHMRC Fellowship (GNT1007994) | en_AU |
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