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Title: Estimation of the costs of cervical cancer screening, diagnosis and treatment in rural Shanxi Province, China: a micro-costing study
Authors: Shi JF; Li ZF; Lew JB; Ning Y; Qiao YL; Chen JF; Canfell K; Feng XX; Ma JF; Zhang YZ; Zhao FH; Li R; Ma L
Categories: Cancer Type - Cervical Cancer
Cancer Control, Survivorship, and Outcomes Research - Health Services, Economic and Health Policy Analyses
Keywords: Biopsy; screening; Women; cancer; cervical; Cervical Cancer; China; diagnosis; Hospitals; Interviews; methods
Year: 2012
Journal Title: BMC Health Services Research
Volume: 12
Issue: 1
Page number start: 123
Abstract: ABSTRACT: BACKGROUND: Cost estimation is a central feature of health economic analyses. The aim of this study was to use a micro-costing approach and a societal perspective to estimate aggregated costs associated with cervical cancer screening, diagnosis and treatment in rural China. METHODS: We assumed that future screening programs will be organized at a county level (population ~250,000), and related treatments will be performed at county or prefecture hospitals; therefore, this study was conducted in a county and a prefecture hospital in Shanxi during 2008-9. Direct medical costs were estimated by gathering information on quantities and prices of drugs, supplies, equipment and labour. Direct non-medical costs were estimated via structured patient interviews and expert opinion. RESULTS: Under the base case assumption of a high-volume screening initiative (11,475 women screened annually per county), the aggregated direct medical costs of visual inspection, selfsampled careHPV (Qiagen USA) screening, clinician-sampled careHPV, colposcopy and biopsy were estimated as US$2.64, $7.49, $7.95, $3.90 and $5.76, respectively. Screening costs were robust to screening volume (<5% variation if 2,000 women screened annually), but costs of colposcopy/biopsy tripled at the lower volume. Direct medical costs of Loop Excision, Cold-Knife Conization and Simple and Radical Hysterectomy varied from $61- $544, depending on the procedure and whether conducted at county or prefecture level. Direct non-medical expenditure varied from $0.68-$3.09 for screening/diagnosis and $83- $494 for pre-cancer/cancer treatment. CONCLUSIONS: Diagnostic costs were comparable to screening costs for high-volume screening but were greatly increased in lower- volume situations, which is a key consideration for the scale-up phase of new programs. The study's findings will facilitate cost-effectiveness evaluation and budget planning for cervical cancer prevention initiatives in China
Programme: Epi Mod Screen
Division: Cancer Research Division
DOI: 10.1186/1472-6963-12-123
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