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Cited by 56Cervical Cancer and HPV ResearchWomen's cancer prevention and managementHealth Systems, Economic Evaluations, Quality of Life

When and how often to screen for cervical cancer in three low- and middle-income countries: a cost-effectiveness analysis

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Campos, Nicole G., Tsu, Vivien, Jeronimo, Jose, Mvundura, Mercy, Lee, Kyueun, Kim, Jane J.·2015·Papillomavirus Research
DOI 10.1016/j.pvr.2015.05.003PMC PMC5886851
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Abstract

World Health Organization guidelines recommend that cervical cancer screening programs should prioritize screening coverage in women aged 30 to 49 years. Decisions about target ages and screening frequency depend upon local burden of disease, costs, and capacity. We used cost and test performance data from the START-UP demonstration projects in India, Nicaragua, and Uganda to evaluate the cost-effectiveness of screening at various start ages, intervals, and frequencies. We calibrated a mathematical simulation model of cervical carcinogenesis to each country and compared screening with care HPV (cervical and vaginal sampling), visual inspection with acetic acid (VIA), and cytology between the ages of 25 and 50 years, at frequencies of once to three times in a lifetime, at 5- and 10-year intervals. Screening with care HPV (cervical sampling) was the most effective and cost-effective strategy in all settings; care HPV (vaginal sampling) was only slightly less effective. The most critical ages for screening are between ages 30 and 45 years. Within this age range, screening at certain ages may be relatively more cost-effective, but cancer risk reductions are similar for a given screening test and interval. Screening three times between 30 and 45 years was very cost-effective and reduced cancer risk by ~50%.

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Cited by

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Authors
Campos, N. G., Tsu, V., Jeronimo, J., Mvundura, M., Lee, K., & Kim, J. J.
Affiliations
  • Harvard University (US)
  • Program for Appropriate Technology in Health (US)
Corresponding author
Campos, Nicole G.
ORCID
Venue
Papillomavirus Research
Publisher
Elsevier BV
Published
2015-12
Volume
1
Pages
38-58
ISSN
2405-8521 (ISSN-L)
DOI
10.1016/j.pvr.2015.05.003
PMC
PMC5886851
OpenAlex
W572673044
Cited by
56
References
5
Citations by year
2026: 3 · 2025: 3 · 2024: 5 · 2023: 3 · 2022: 5 · 2021: 6 · 2020: 6 · 2019: 5 · 2018: 7 · 2017: 7 · 2016: 6
FWCI
5.22
Type
journal article
Language
en
Open access
Licence
Locations
  • Papillomavirus Research (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by-nc-nd)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
Funders
Harvard T.H. Chan School of Public Health
Topics
  • Health Sciences › Medicine › Epidemiology › Cervical Cancer and HPV Research
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Women's cancer prevention and management
  • Social Sciences › Economics, Econometrics and Finance › Economics and Econometrics › Health Systems, Economic Evaluations, Quality of Life
Keywords
cervical cancer screening, cost-effectiveness, screening frequency, screening age, HPV testing, visual inspection with acetic acid, cervical cytology, low- and middle-income countries, cancer risk reduction

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