Economic Evaluation of Three Populational Screening Strategies for Cervical Cancer

The aim of this study was to compare the effectiveness and the costs of three types of population interventions to increase the number of female participants in the screening programmes for cancer of the cervix carried out by Primary Care in four Basic Health Care Areas.

Sex

Female

Minimum age

30 Years

Maximum age

70 Years

Inclusion Criteria:

20,994 women from 30 to 70 years of age with incorrect screening criteria (data obtained from Electronic Medical Records) ascribed to the Basic Health Care Area will be included in the study. Incorrect screening will be defined as \[9\]:

1. \- No cytology in the last 3 years from women between 30 to 40 years,
2. \- No cytology in the previous 5 years from women between 40 to 65 years,
3. \- No previous cytology history for females older than 65 years or women who have not had their last cytology before the age of 60

Exclusion Criteria:

* hysterectomised women, with a current history of pre-malignant lesions (Atypical glandular cells of undetermined significance, Atypical squamous cells of undetermined significance, Low grade Squamous Intraepithelial Lesion, High grade Squamous Intraepithelial Lesion), carcinoma in situ and cervical-uterine cancer, HIV positive or other causes of immunosuppression (since these women follow a specific protocol);
* those residing outside the study setting for more than 6 months;
* those ascribed to the study Basic Health Care Area but with a physician assigned in an UBA (General Practicioner and Nurse Team) of another zone different from the one considered in the study

• DERIVEDTrapero-Bertran M, Acera Perez A, de Sanjose S, Manresa Dominguez JM, Rodriguez Capriles D, Rodriguez Martinez A, Bonet Simo JM, Sanchez Sanchez N, Hidalgo Valls P, Diaz Sanchis M. Cost-effectiveness of strategies to increase screening coverage for cervical cancer in Spain: the CRIVERVA study. BMC Public Health. 2017 Feb 14;17(1):194. doi: 10.1186/s12889-017-4115-0. PMID 28196467
• DERIVEDAcera A, Manresa JM, Rodriguez D, Rodriguez A, Bonet JM, Trapero-Bertran M, Hidalgo P, Sanchez N, de Sanjose S. Increasing Cervical Cancer Screening Coverage: A Randomised, Community-Based Clinical Trial. PLoS One. 2017 Jan 24;12(1):e0170371. doi: 10.1371/journal.pone.0170371. eCollection 2017. PMID 28118410
• DERIVEDAcera A, Manresa JM, Rodriguez D, Rodriguez A, Bonet JM, Sanchez N, Hidalgo P, Soteras P, Toran P, Trapero-Bertran M, Lozano I, De Sanjose S. Analysis of three strategies to increase screening coverage for cervical cancer in the general population of women aged 60 to 70 years: the CRICERVA study. BMC Womens Health. 2014 Jul 16;14:86. doi: 10.1186/1472-6874-14-86. PMID 25026889
• DERIVEDAcera A, Rodriguez A, Trapero-Bertran M, Soteras P, Sanchez N, Bonet JM, Manresa JM, Hidalgo P, Toran P, Prieto G. Economic evaluation of three populational screening strategies for cervical cancer in the county of Valles Occidental: CRICERVA clinical trial. BMC Health Serv Res. 2011 Oct 19;11:278. doi: 10.1186/1472-6963-11-278. PMID 22011387