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Costs of cervical cancer and precancerous lesions treatment in a publicly financed health care system

  • Gynecologic Oncology
  • Published:
Archives of Gynecology and Obstetrics Aims and scope Submit manuscript

Abstract

Purpose

Although cervical cancer is the most frequent cancer for women in Taiwan, no examination of its treatment costs has yet been undertaken. This study aimed to investigate the costs of cervical cancer and precancerous lesion treatment in Taiwan.

Methods

A total of 7,398 cases of cervical intraepithelial neoplasia (CIN) lesions were identified from the Taiwan Cervical Cancer Screening Registration System in 2003. A further 1,469 cases of invasive cervical cancer (ICC) were also identified from a survey on cervical cancer staging information conducted by the Taiwan Cancer Registration Task Force. Resource usage covering the first 6 months after CIN diagnosis and the 5 years after ICC diagnosis were extracted from the National Health Insurance claims database. The duration of each visit and the transportation costs were collected by means of personal interviews with CIN/ICC patients. The mean and standard deviation of the treatment and indirect costs were estimated.

Results

The average total costs for CIN patients were NT$4,201 for CIN1, NT$8,623 for CIN2 and NT$14,406 for CIN3, with the indirect costs accounting for 25–33% of the total. The total costs for ICC patients were NT$210,230 for Stage 1, NT$392,387 for Stage 2, NT$433,969 for Stage 3 and NT$464,701 for Stage 4, with the indirect costs accounting for about 14–17% of the total.

Conclusions

CIN and ICC treatment resulted in considerable costs to the healthcare system in Taiwan. Indirect costs associated with such treatment were also substantial and cannot be ignored.

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Abbreviations

NHI:

National Health Insurance

CIN:

Intraepithelial neoplasia

ICC:

Invasive cervical cancer

HPV:

Human papillomavirus

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Acknowledgments

The financial support provided for this research by the Bureau of Health Promotion, the Department of Health and GlaxoSmithKline in Taiwan, is gratefully acknowledged. It should be noted, however, that the authors did retain full independence in the preparation of the manuscript. The authors would also like to thank the Office of Statistics at the Department of Health, the Bureau of National Health Insurance, the Taiwan Cancer Registry System task force, as well as the Taiwan Cervical Cancer Screening Registration System task force, for their technical assistance in making the data available for this study. The authors are also grateful for the assistance provided by the medical staff at the Departments of Obstetrics and Gynecology at the National Taiwan University and the National Cheng Kung University, as well as the public health staff in the Taoyuan and Tainan Public Health Bureaus. The individual contributions of each of the authors are as follows. C.-H. Tang and R.-F. Pwu identified the study issue, designed the methods, analyzed the data, and drafted the manuscript. H.-I. Wang and I.-C. Tsai performed the statistical analysis and participated in the writing of the manuscript. C.-A. Chen, P.-A. Scuffham, C.-Y. Hsieh, C.-Y. Chou, S.-R. Lin, Y.-D. Chen and C.-J. Chen helped conceptualize the ideas and synthesize the analyses. S.-L. You assisted with the analyses and editing. All of the authors helped to interpret the findings and revise the manuscript drafts, and approved the final manuscript.

Conflict of interest statement

Chao-Hsiun Tang has received partial funding from GlaxoSmithKline Far East B. V., Taiwan Branch to conduct the study. She also received honorarium from GlaxoSmithKline Far East B. V., Taiwan Branch for giving speeches on cervical cancer cost and cost effectiveness of HPV vaccines in Taiwan. I-Ching Tsai was an employee of GlaxoSmithKline when this study was performed.

Author information

Authors and Affiliations

  1. School of Health Care Administration, Taipei Medical University, No. 250, Wu Xing Street, Xing Yi District, Taipei, 110, Taiwan

    Chao-Hsiun Tang, Raoh-Fang Pwu & Han-I Wang

  2. Gynecology Research Center, Taipei Medical University Hospital, No. 252, Wu Xing Street, Xing Yi District, Taipei, 110, Taiwan

    Chao-Hsiun Tang

  3. Center for Drug Evaluation, 1st Floor, No. 15-1, Sect. 1, Hangjou South Road, Jhongjheng District, Taipei, 100, Taiwan

    Raoh-Fang Pwu

  4. Janssen Cilag Taiwan, 8th Floor, No. 319, Sect. 2, Tunhwa South Road, Da-an District, Taipei, 106, Taiwan

    I-Ching Tsai

  5. Genomics Research Center, Academia Sinica, No. 128, Sect. 2, Academia Road, Nankang District, Taipei, 115, Taiwan

    San-Lin You & Chien-Jen Chen

  6. School of Public Health, National Defense Medical Center, No. 161, Sect. 6, Min-Chuan East Road, Neihu District, Taipei, 114, Taiwan

    San-Lin You

  7. Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, No. 1, Sect. 1, Ren-ai Road, Jhongjheng District, Taipei, 100, Taiwan

    Chi-An Chen & Chang-Yao Hsieh

  8. School of Medicine, Logan campus, Griffith University, Meadowbrook, QLD, 4131, Australia

    Paul A. Scuffham

  9. Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, No. 1, University Road, East District, Tainan, 701, Taiwan

    Cheng-Yang Chou

  10. Bureau of Food Safety, Department of Health, 4th Floor, No. 80, Linsen North Road, Zhongshan District, Taipei, 104, Taiwan

    Sheue-Rong Lin

  11. Tainan County Health Bureau, No. 163, Dongsing Road, Sinying City, Tainan County, 730, Taiwan

    Yao-Der Chen

  12. Graduate Institute of Epidemiology, College of Public Health, National Taiwan University, No. 17, Syujhou Road, Jhongjheng District, Taipei, 100, Taiwan

    Chien-Jen Chen

Authors
  1. Chao-Hsiun Tang
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  2. Raoh-Fang Pwu
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  3. I-Ching Tsai
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  4. Han-I Wang
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  5. San-Lin You
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  6. Chi-An Chen
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  7. Paul A. Scuffham
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  8. Chang-Yao Hsieh
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  9. Cheng-Yang Chou
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  10. Sheue-Rong Lin
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  11. Yao-Der Chen
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  12. Chien-Jen Chen
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Corresponding author

Correspondence to Chao-Hsiun Tang.

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Tang, CH., Pwu, RF., Tsai, IC. et al. Costs of cervical cancer and precancerous lesions treatment in a publicly financed health care system. Arch Gynecol Obstet 281, 683–695 (2010). https://doi.org/10.1007/s00404-009-1218-6

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  • DOI: https://doi.org/10.1007/s00404-009-1218-6

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