Economic evaluation of human papillomavirus screening in Germany

  • T. Mittendorf
  • K. U. Petry
  • T. Iftner
  • W. Greiner
  • J. M. von der Schulenburg
Original Papers

Abstract

Cytology-based screening programs for cervical cancer have been effective in reducing cancer incidence and preventing premature deaths worldwide. However, there is concern about the relatively low sensitivity of current screening procedures. Although the causal association between infection with certain high-risk types of human papilloma virus (HPV) and the development of cervical cancer has been clearly established, testing for the major risk factor is not part of current screening practice. We created a tree decision model over time to evaluate different policy choices for implementing a population-based screening program. Results of the economic analysis indicate that testing with any implemented HPV DNA testing (stand alone or in combination with the Papanicolaou smear) is superior to cytology and measures presently in use. Additional costs per life-years gained cannot be reported because the HPV branches had fewer discounted overall costs (€222 million vs. €82 and €76 million, respectively), and they saved more life years (19,599 vs. 19,163 and 903, respectively) then the smear alternative. Any HPV DNA testing is preferable over the current state of the art performed in Germany. This is true not only for economic reasons but also for life-years gained. Therefore HPV DNA testing must become an essential component to back up the relatively weak sensitivity of the standard procedure.

Keywords

Human papillomavirus Screening Cervical cancer Prevention Health policy 

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Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • T. Mittendorf
    • 1
    • 4
  • K. U. Petry
    • 2
  • T. Iftner
    • 3
  • W. Greiner
    • 1
  • J. M. von der Schulenburg
    • 1
  1. 1.Centre for Health Economics and Health System ResearchUniversity of HanoverGermany
  2. 2.Department of Gynecological OncologyUniversity of HanoverGermany
  3. 3.Section of Experimental VirologyEberhardt Karls University of TübingenGermany
  4. 4.Centre for Health Economics and Health System ResearchUniversity of HanoverHanoverGermany

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