Cervical cancer screening in low- and middle-income countries: A systematic review of economic evaluation studies
Clinics
; 77: 100080, 2022. tab, graf
Article
in English
|
LILACS-Express
| LILACS
| ID: biblio-1404327
Responsible library:
BR1.1
ABSTRACT
Abstract Economic assessments are relevant to support the decision to incorporate more cost-effective strategies to reduce Cervical Cancer (CC) mortality. This systematic review analyzes the economic evaluation studies of CC prevention strategies (HPV DNA-based tests and conventional cytology) in low- and middle-income countries. Medline, EMBASE, CRD, and LILACS were searched for economic evaluation studies that reported cost and effectiveness measures of HPV DNA-based tests for CC screening and conventional cytology in women, without age, language, or publication date restrictions. Selection and data extraction were carried out independently. For comparability of results, cost-effectiveness measures were converted to international dollars (2019). Report quality was assessed using the CHEERS checklist. The Dominance Matrix Ranking (DRM) was used to analyze and interpret the results. The review included 15 studies from 12 countries, with cost-effectiveness analyzes from the health system's perspective and a 3% discount rate. The strategies varied in age and frequency of screening. Most studies used the Markov analytical model, and the cost-benefit threshold was based on the per capita GDP of each country. The sensitivity analysis performed in most studies was deterministic. The completeness of the report was considered sufficient in most of the items evaluated by CHEERS. The Dominance Interpretation (DRM) varied; in 6 studies, the HPV test was dominant, 5 studies showed a weak dominance evaluating greater effectiveness of the HPV test at a higher cost, yet in 2 studies conventional cytology was dominant. Although the context-dependent nature of economic evaluations, this review points out the challenge of methodological standardization in the analytical models.
Full text:
Available
Collection:
International databases
Health context:
SDG3 - Target 3.4 Reduce premature mortality due to noncommunicable diseases
Health problem:
Cervical Cancer
Database:
LILACS
Type of study:
Diagnostic study
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Health economic evaluation
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Prognostic study
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Screening study
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Systematic review
Language:
English
Journal:
Clinics
Journal subject:
Medicine
Year:
2022
Document type:
Article
Affiliation country:
Brazil
Institution/Affiliation country:
Agência Nacional de Vigilância Sanitária (ANVISA)/BR
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Fundação Oswaldo Cruz (FIOCRUZ)/BR
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Hospital Alemão Oswaldo Cruz (HAOC)/BR
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Instituto Nacional de Câncer (INCA)/BR
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EBSERH)+BR
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Universidade Federal do Espírito Santo (UFES)/BR