Please use this identifier to cite or link to this item:
https://www.um.edu.mt/library/oar/handle/123456789/127438
Title: | Systematic review of cost-effectiveness studies on cervical cancer screening across Europe |
Authors: | Harasani, Klejda Vasileva-Slaveva, Mariela Yordanov, Angel Tripac-Iacovleva, Irina Calleja-Agius, Jean |
Keywords: | Cervix uteri -- Cancer -- European Union countries Medical screening -- European Union countries Health risk assessment -- European Union countries Cost effectiveness Systematic reviews (Medical research) |
Issue Date: | 2024 |
Publisher: | Elsevier Ltd |
Citation: | Harasani, K., Vasileva-Slaveva, M., Yordanov, A., Tripac, I., & Calleja-Agius, J. (2024). Systematic review of cost-effectiveness studies on cervical cancer screening across Europe. European Journal of Surgical Oncology, doi: 10.1016/j.ejso.2024.108742. |
Abstract: | Introduction: Cervical cancer (CC) is a type of cancer with poor prognosis when diagnosed in advanced stage with a big socioeconomic burden. The incidence rates have wide variations among European countries depending on the implementation or not of screening, vaccination programs and the human development index (HDI). Most studies on cost-effectiveness of CC screening programs are carried out in countries with a high HDI, however more recent reviews of screening approaches are coming from countries with lower HDI aiming to identify the best screening strategies. Our study aims to identify which are the currently applied and most cost-effective strategies of CC screening in Europe. Materials and methods: This is a systematic review conducted in three different databases (PubMed, Scopus and ScienceDirect) and reported following the PRISMA guidelines. General key terms for all databases were the following: cost-effectiveness, cervical cancer, screening, Europe. We included studies in English, Italian, Spanish and Bulgarian, published in the last 25 years, reporting data on cost-effectiveness of CC screening, costs and outcome measures. The methodological quality of the articles was evaluated with a standardized tool. Results: A total of 262 studies were identified and 22 studies were included in the final analysis. In 90.1 % of the economic studies, the new screening strategy was shown to be more cost-effective compared to the current one or compared to no screening. The optimal strategy mostly involved primary HPV testing, combined with cytology or as stand-alone screening technique. Several scenarios differing on starting age and periodicities for CC screening, combination of techniques and triage, were found to be cost-effective and below the willingness to pay (WTP) threshold. The methodology of all included studies was assessed from 10 to 11 on the JBI standardized tool and Drummond 11-point checklist. Conclusion: Numerous cost-effective options for CC screening in different European countries were identified in this systematic review. HPV testing, with or without cytology, mainly starting at 30 years of age and repeated every 5 years or more was the most cost-effective technique. Future studies should focus on the most appropriate CC screening approach for each context and setting, also considering HPV vaccination in Europe. |
URI: | https://www.um.edu.mt/library/oar/handle/123456789/127438 |
Appears in Collections: | Scholarly Works - FacM&SAna |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
Systematic_review_of_cost_effectiveness_studies_on_cervical_cancer_screening_across_Europe_2024.pdf Restricted Access | 1.77 MB | Adobe PDF | View/Open Request a copy |
Items in OAR@UM are protected by copyright, with all rights reserved, unless otherwise indicated.