Mejía Aurelio, Salas Walter
Grupo de Economía de la Salud, Facultad de Ciencias Económicas, Universidad de Antioquia, Medellín, Colombia.
Biomedica. 2008 Mar;28(1):160-72.
Human papilloma virus DNA testing may improve the cost effectiveness of cervical cancer screening programs. However, the circumstances to get this improvement are not the same between countries. The objective of this paper is to evaluate the cost effectiveness of introducing human papilloma virus testing in the current screening practice both in developed and developing countries. We conducted a review of published articles since January 2000 until December 2006 related to the cost effectiveness of introducing human papilloma virus testing in cervical cancer screening programs. A total of 17 original researches and six reviews were analyzed. Human papilloma virus testing is cost effective in developed countries only if it is a complementary test to Pap test and used to determine the management of women with atypical squamus cells of undetermined significance, the interval among tests is increased more than two years and it is performed in women over 30 years. On the other hand, developing countries should establish first organized screening programs and guarantee full coverage and access to diagnosis and treatment.
人乳头瘤病毒DNA检测可能会提高宫颈癌筛查项目的成本效益。然而,各国实现这种改善的情况并不相同。本文的目的是评估在发达国家和发展中国家的当前筛查实践中引入人乳头瘤病毒检测的成本效益。我们对2000年1月至2006年12月期间发表的与在宫颈癌筛查项目中引入人乳头瘤病毒检测的成本效益相关的文章进行了综述。共分析了17项原创研究和6篇综述。人乳头瘤病毒检测仅在作为巴氏试验的补充检测、用于确定意义不明确的非典型鳞状细胞女性的管理、检测间隔增加超过两年且在30岁以上女性中进行时,在发达国家才具有成本效益。另一方面,发展中国家应首先建立有组织的筛查项目,并确保全面覆盖以及获得诊断和治疗的机会。