Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Research article

Cost-effectiveness of strategies to increase screening coverage for cervical cancer in Spain: the CRIVERVA study

Authors: Marta Trapero-Bertran, Amelia Acera Pérez, Silvia de Sanjosé, Josep Maria Manresa Domínguez, Diego Rodríguez Capriles, Ana Rodriguez Martinez, Josep Maria Bonet Simó, Norman Sanchez Sanchez, Pablo Hidalgo Valls, Mireia Díaz Sanchis

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

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.

Methods

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.

Results

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.

Conclusions

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.

Trial registration

ClinicalTrials.gov Identifier: NCT01373723.
Appendix
Available only for authorised users
Literature
1.
de Sanjosé Llongueras S and García García AM. Virus del Papiloma Humano y Cáncer: Epidemiología y Prevención. 4ª Monografía de la Sociedad Española de Epidemiología. 2006. ISBN: 690-0811-0.
2.
Allemani C, Weir HK, Carreira H, Harewood R, Spika D, Wang X-S, et al. Global surveillance of cancer survival 1995-2009: analysis of individual data for 25 676 887 patients from 279 population-based registries in 67 countries (CONCORD-2). Lancet. 2015;385(9972):977–1010.CrossRefPubMed
3.
Ferlay J, Soerjomataram I, Ervik M, Dikshit R, Eser S, Mathers C, et al. Cancer incidence and mortality worldwide: IARC CancerBase No. 11. Lyon, France: International Agency for Research on Cancer. GLOBOCAN 2012 v1.0. http://​globocan.​iarc.​fr. Accessed on January 2016].
4.
Clèries R, Esteban L, Borràs J, Marcos-Gragera R, Freitas A, Carulla M, et al. Time trends of cancer incidence and mortality in Catalonia during 1993–2007. Clin Transl Oncol. 2014;16(1):18–28.CrossRefPubMed
5.
Luengo-Fernández R, Leal J, Gray A, Sullivan R. Economic burden of cancer across the European Union: a population-based cost analysis. Lancet. 2013;14(12):1165–74.CrossRefPubMed
6.
7.
Anttila A, Ronco G. Description of the national situation of cervical cancer screening in the member states of the European Union. Eur J Cancer. 2009;45:2685–708.CrossRefPubMed
8.
European CDC (ECDC). Guidance for the introduction of hpv vaccines in European Union countries. Stockholm: European Centre for Disease Prevention and Control; 2008.
9.
Everett T, Bryant A, Griffin MF, Martin-Hirsch PPL, Forbes CA, Jepson RG. Interventions targeted at women to encourage the uptake of cervical screening. Cochrane Database Syst Rev. 2011;5:CD002834.
10.
Sabatino SA, Lawrence B, Elder R, Mercer SL, Wilson KM, DeVinney B, et al. Effectiveness of interventions to increase screening for breast, cervical, and colorectal cancers: nine updated systematic reviews for the guide to community preventive services. Am J Prev Med. 2012;43:97–118.CrossRefPubMed
11.
Dinkelspiel H, Fetterman B, Poitras N, Kinney W, Cox JT, Lorey T, et al. Screening history preceding a diagnosis of cervical cancer in women age 65 and older. Gynecol Oncol. 2012;126:203–6.CrossRefPubMed
12.
Acera A, Rodriguez A, Trapero-Bertran M, Soteras P, Sanchez N, Bonet JM, et al. Economic evaluation of three populational screening strategies for cervical cancer in the county of Valles Occidental: CRICERVA clinical trial. BMC Health Serv Res. 2011;11:278.CrossRefPubMedPubMedCentral
13.
Georgalis L, de Sanjosé S, Esnaola M, Bosch FX, Diaz M. Present and future of cervical cancer prevention in Spain: a cost-effectiveness analysis. Eur J Cancer Prev. 2015. Epub ahead of print.
14.
Atenció a la Salut Sexual i Reproductiva Cerdanyola: Productes Intermedis. Area Metropolitana Nord. Institut Català de la Salut. Generalitat de Catalunya; 2014.
15.
16.
Gray AM, Clarke PM, Wolstenholme JL, Wordsworth S. Applied methods of cost-effectiveness analysis in health care. Oxford: Oxford University Press; 2011.
17.
Hyndman JC, Straton JA, Pritchard DA, Le Sueur H. Cost-effectiveness of interventions to promote cervical screening in general practice. Aust New Zeland J Public Health. 1996;20(3):272–7.CrossRef
18.
Broberg G, Miao Jonasson J, Ellis J, Gyrd-Hansen D, Anjemark B, Glantz A, et al. Increasing participation in cervical cancer screening: telephone contact with long-term non-attendees in Sweden. Results from RACOMIP, a randomized controlled trial. Int J Cancer. 2013;133(1):164–71.CrossRefPubMed
19.
Heranney D, Fender M, Velten M, Baldauf JJ. A prospective randomized study of two reminding strategies: telephone versus mail in the screening of cervical cancer in women who did not initially respond. Acta Cytol. 2011;55(4):334–40.CrossRefPubMed
20.
Kesic V, Poljak M, Rogovskaya S. Cervical cancer burden and prevention activities in Europe. Cancer Epidemiol Biomarkers Prev. 2012;21(9):1423–33.CrossRefPubMed
21.
Anttila A, von Karsa L, Aasmaa A, Fender M, Patnick J, Rebolj M, et al. Cervical cancer screening policies and coverage in Europe. Eur J Cancer. 2009;45(15):2649–58.CrossRefPubMed
22.
Arbyn M, Anttila A, Jordan J, Ronco G, Schenck U, Segnan N, et al. European guidelines for quality assurance in cervical cancer screening. 2nd ed. Brussels, Luxemburg: European Community, Office for Official publications of the European Communities; 2008.
23.
Nicula FA, Anttila A, Neamtiu L, Primic Zakelj M, Tachezy R, Chil A, et al. Challenges in starting organised screening programmes for cervical cancer in the new member states of the European Union. Eur J Cancer. 2009;45(15):2679–84.CrossRefPubMed
24.
Virtanen A, Anttila A, Luostarinen T, Malila N, Nieminen P. Improving cervical cancer screening attendance in Finland. Int J Cancer. 2015;136(6):E667–84.CrossRef
25.
Spadea T, Bellini S, Kunst A, Stirbu I, Costa G. The impact of interventions to improve attendance in female cancer screening among lower socioeconomic groups: a review. Prev Med. 2010;50(4):159–64.CrossRefPubMed
26.
De Sanjosé S, Garcia AM. Virus del papiloma humano y cáncer: epidemiología y prevención. Madrid: 4a Monografía de la Sociedad Española de Epidemiologia; 2006. p. 1–144.
27.
Siebert U, Sroczynski G, Hillemans P, Engel J, Stabenow R, Stegmaier C, et al. The German cervical cancer screening model: development and validation of a decision-analytic model for cervical cancer screening in Germany. Eur J Public Health. 2006;16(2):185–92.CrossRefPubMed
Metadata
Title
Cost-effectiveness of strategies to increase screening coverage for cervical cancer in Spain: the CRIVERVA study
Authors
Marta Trapero-Bertran
Amelia Acera Pérez
Silvia de Sanjosé
Josep Maria Manresa Domínguez
Diego Rodríguez Capriles
Ana Rodriguez Martinez
Josep Maria Bonet Simó
Norman Sanchez Sanchez
Pablo Hidalgo Valls
Mireia Díaz Sanchis
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4115-0

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Research article

“I would rather be told than not know” - A qualitative study exploring parental views on identifying the future risk of childhood overweight and obesity during infancy

Research article

Contraceptive knowledge, perceptions, and concerns among men in Uganda

Research article

Risk of disability pension in first and second generation immigrants: the role of age and region of birth in a prospective population-based study from Sweden

Research article

Noticing cigarette health warnings and support for new health warnings among non-smokers in China: findings from the International Tobacco Control project (ITC) China survey

Research article

Health and healthcare disparities among U.S. women and men at the intersection of sexual orientation and race/ethnicity: a nationally representative cross-sectional study

Research article

Reducing waiting time and raising outpatient satisfaction in a Chinese public tertiary general hospital-an interrupted time series study