Cost-effectiveness of strategies to increase screening coverage for cervical cancer in Spain : the CRIVERVA study
Trapero Bertrán, Marta (Universitat Internacional de Catalunya. Departament d'Economia i Organització d'Empreses)
Acera Pérez, Amelia (Institut Català de la Salut)
De Sanjose, Silvia (Institut Català d'Oncologia)
Manresa, J. M (Universitat Autònoma de Barcelona. Departament d'Infermeria)
Rodríguez Capriles, Diego (Institut Català de la Salut)
Rodríguez Martínez, Ana (Institut Català de la Salut)
Bonet Simó, Josep Maria (Institut Català de la Salut)
Sánchez Sánchez, Norman (Institut Català de la Salut)
Hidalgo Valls, Pablo (Institut Català de la Salut)
Díaz Sanchís, Mireia (Institut Català d'Oncologia)

Date:	2017
Abstract:	The aim of the study is to carry out a cost-effectiveness analysis of three different interventions to promote the uptake of screening for cervical cancer in general practice in the county of Valles Occidental, Barcelona, Spain. Women aged from 30 to 70 years (n = 15,965) were asked to attend a general practice to be screened. They were randomly allocated to one of four groups: no intervention group (NIG); one group where women received an invitation letter to participate in the screening (IG1); one group where women received an invitation letter and informative leaflet (IG2); and one group where women received an invitation letter, an informative leaflet and a phone call reminder (IG3). Clinical effectiveness was measured as the percentage increase in screening coverage. A cost-effectiveness analysis was performed from the perspective of the public health system with a time horizon of three to five years - the duration of the randomised controlled clinical trial. In addition, a deterministic sensitivity analysis was performed. Results are presented according to different age groups. The incremental cost-effectiveness ratio (ICER) for the most cost-effective intervention, IG1, compared with opportunistic screening was € 2. 78 per 1% increase in the screening coverage. The age interval with the worst results in terms of efficiency was women aged < 40 years. In a population like Catalonia, with around 2 million women aged 30 to 70 years and assuming that 40% of these women were not attending general practice to be screened for cervical cancer, the implementation of an intervention to increase screening coverage which consists of sending a letter would cost on average less than € 490 for every 1000 women. ClinicalTrials. gov Identifier: . The online version of this article (doi:10. 1186/s12889-017-4115-0) contains supplementary material, which is available to authorized users.
Grants:	Instituto de Salud Carlos III RD06/0020-0095 Instituto de Salud Carlos III RD12-0036-0056 European Commission 603019 Agència de Gestió d'Ajuts Universitaris i de Recerca 2014/SGR-1077 Agència de Gestió d'Ajuts Universitaris i de Recerca 2014/SGR-2016 Agència de Gestió d'Ajuts Universitaris i de Recerca 2014/SGR-756 Instituto de Salud Carlos III PI11-02090 Instituto de Salud Carlos III PI14-01219 Instituto de Salud Carlos III PI16-01254 Instituto de Salud Carlos III CB06-02-0073 Instituto de Salud Carlos III CB16-12-00401 Instituto de Salud Carlos III RD12-0036-0056
Note:	Altres ajuts: MSSSI/PI10-01275
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Cost-effectiveness ; Population screening ; Cervical cancer ; Increase coverage
Published in:	BMC public health, Vol. 17 (February 2017) , art. 194, ISSN 1471-2458

DOI: 10.1186/s12889-017-4115-0
PMID: 28196467

Published version 8 p, 377.2 KB

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