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Economic evaluation of human papillomavirus screening in Germany

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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.

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Acknowledgements

The data from the German trials in this study were collected by assessing the Hybrid Capture II array manufactured by Digene Corporation, Gaithersburg, Md., USA. These trials were supported by an unrestricted grant from Digene Corporation to the participating universities.

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Authors and Affiliations

  1. Centre for Health Economics and Health System Research, University of Hanover, Germany

    T. Mittendorf, W. Greiner & J. M. von der Schulenburg

  2. Department of Gynecological Oncology, University of Hanover, Germany

    K. U. Petry

  3. Section of Experimental Virology, Eberhardt Karls University of Tübingen, Germany

    T. Iftner

  4. Centre for Health Economics and Health System Research, University of Hanover, Königsworther Platz 1, 30167, Hanover, Germany

    T. Mittendorf

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  1. T. Mittendorf
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  2. K. U. Petry
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  3. T. Iftner
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  4. W. Greiner
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  5. J. M. von der Schulenburg
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Correspondence to T. Mittendorf.

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Mittendorf, T., Petry, K.U., Iftner, T. et al. Economic evaluation of human papillomavirus screening in Germany. HEPAC 4, 209–215 (2003). https://doi.org/10.1007/s10198-003-0187-0

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