Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis

Sroczynski G, Schnell-Inderst P, Muehlberger N, Lang K, Aidelsburger P, Wasem J, Mittendorf T, Engel J, Hillemanns P, Petry KU, Krämer A, et al. (2011)
European Journal of Cancer 47(11): 1633-1646.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
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Autor*in
Sroczynski, G.; Schnell-Inderst, P.; Muehlberger, N.; Lang, K.; Aidelsburger, P.; Wasem, J.; Mittendorf, T.; Engel, J.; Hillemanns, P.; Petry, K. U.; Krämer, AlexanderUniBi ; Siebert, U.
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Abstract / Bemerkung
Objectives: To systematically evaluate the long-term effectiveness and cost-effectiveness of HPV-based primary cervical cancer screening in the German health care context using a decision-analysis approach. Methods: A Markov-model for HPV-infection and cervical cancer was developed for the German health care context, and applied to evaluate various screening strategies that differ by screening interval and test algorithms, including HPV-testing alone or in combination with cytology. German clinical, epidemiological, and economic data, and test accuracy data from international meta-analyses were used. Outcomes predicted included the reduction in cervical cancer cases and deaths, life expectancy and discounted incremental cost-effectiveness ratios (ICER). The analysis was performed from the perspective of the healthcare system adopting a 3% annual discount rate for costs and outcomes. Extensive sensitivity analyses were performed. Results: HPV-based screening is more effective than cytology alone. It results in a 71-97% reduction in cervical cancer cases as compared to 53-93% for cytology alone. The ICER range from 2600 Euro/LYG (cytology, 5-year-interval) to 155,500 Euro/LYG (annual HPV-testing starting at age 30 years, cytology age 20-29 years). Annual cytology alone, the current recommended screening strategy in Germany, is dominated by HPV-strategies. Increasing the age at screening initiation from 20 to 25 years does not result in a relevant loss in effectiveness but results in lower costs. Conclusions: Based on our analyses, HPV-based cervical cancer screening is more effective than cytology alone and could be cost-effective if performed at intervals of two years or longer. In the German context, an optimal screening strategy may be biennial HPV screening starting at age 30 years preceded by biennial cytology for women aged 25-29 years. Longer screening intervals may be considered in low-risk women with good screening adherence and in populations with low HPV-incidence. (C) 2011 Elsevier Ltd. All rights reserved.
Stichworte
Cost-effectiveness; Cost benefit analyses; Decision analysis; Cervical cancer; Human papillomavirus; Screening
Erscheinungsjahr
2011
Zeitschriftentitel
European Journal of Cancer
Band
47
Ausgabe
11
Seite(n)
1633-1646
ISSN
0959-8049
Page URI
https://pub.uni-bielefeld.de/record/2326711

Zitieren

Sroczynski G, Schnell-Inderst P, Muehlberger N, et al. Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis. European Journal of Cancer. 2011;47(11):1633-1646.
Sroczynski, G., Schnell-Inderst, P., Muehlberger, N., Lang, K., Aidelsburger, P., Wasem, J., Mittendorf, T., et al. (2011). Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis. European Journal of Cancer, 47(11), 1633-1646. https://doi.org/10.1016/j.ejca.2011.03.006
Sroczynski, G., Schnell-Inderst, P., Muehlberger, N., Lang, K., Aidelsburger, P., Wasem, J., Mittendorf, T., et al. 2011. “Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis”. European Journal of Cancer 47 (11): 1633-1646.
Sroczynski, G., Schnell-Inderst, P., Muehlberger, N., Lang, K., Aidelsburger, P., Wasem, J., Mittendorf, T., Engel, J., Hillemanns, P., Petry, K. U., et al. (2011). Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis. European Journal of Cancer 47, 1633-1646.
Sroczynski, G., et al., 2011. Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis. European Journal of Cancer, 47(11), p 1633-1646.
G. Sroczynski, et al., “Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis”, European Journal of Cancer, vol. 47, 2011, pp. 1633-1646.
Sroczynski, G., Schnell-Inderst, P., Muehlberger, N., Lang, K., Aidelsburger, P., Wasem, J., Mittendorf, T., Engel, J., Hillemanns, P., Petry, K.U., Krämer, A., Siebert, U.: Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis. European Journal of Cancer. 47, 1633-1646 (2011).
Sroczynski, G., Schnell-Inderst, P., Muehlberger, N., Lang, K., Aidelsburger, P., Wasem, J., Mittendorf, T., Engel, J., Hillemanns, P., Petry, K. U., Krämer, Alexander, and Siebert, U. “Cost-effectiveness of primary HPV screening for cervical cancer in Germany - a decision analysis”. European Journal of Cancer 47.11 (2011): 1633-1646.

10 Zitationen in Europe PMC

Daten bereitgestellt von Europe PubMed Central.

Simple but not simpler: a systematic review of Markov models for economic evaluation of cervical cancer screening.
Viscondi JYK, Faustino CG, Campolina AG, Itria A, Soárez PC., Clinics (Sao Paulo) 73(), 2018
PMID: 29995100
Cost-Effectiveness of Different Cervical Screening Strategies in Islamic Republic of Iran: A Middle-Income Country with a Low Incidence Rate of Cervical Cancer.
Nahvijou A, Daroudi R, Tahmasebi M, Amouzegar Hashemi F, Rezaei Hemami M, Akbari Sari A, Barati Marenani A, Zendehdel K., PLoS One 11(6), 2016
PMID: 27276093
Annual Papanicolaou screening for 5 years among human papillomavirus-negative women.
Petry KU, Rinnau F, Böhmer G, Hollwitz B, Luyten A, Buttmann N, Brünger M, Iftner T., BMC Cancer 13(), 2013
PMID: 23937771
Quality of screening with conventional Pap smear in Austria - a longitudinal evaluation.
Rásky É, Regitnig P, Schenouda M, Burkert N, Freidl W., BMC Public Health 13(), 2013
PMID: 24152300
'It's a can of worms': understanding primary care practitioners' behaviours in relation to HPV using the Theoretical Domains Framework.
McSherry LA, Dombrowski SU, Francis JJ, Murphy J, Martin CM, O'Leary JJ, Sharp L, ATHENS Group., Implement Sci 7(), 2012
PMID: 22862968
State-transition modeling: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force-3.
Siebert U, Alagoz O, Bayoumi AM, Jahn B, Owens DK, Cohen DJ, Kuntz KM., Med Decis Making 32(5), 2012
PMID: 22990084
State-transition modeling: a report of the ISPOR-SMDM Modeling Good Research Practices Task Force--3.
Siebert U, Alagoz O, Bayoumi AM, Jahn B, Owens DK, Cohen DJ, Kuntz KM, ISPOR-SMDM Modeling Good Research Practices Task Force., Value Health 15(6), 2012
PMID: 22999130
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