Atenció a la Salut Sexual i Reproductiva SAP Cerdanyola -Ripollet, Institut Catala de la Salut, Barcelona, Spain.
BMC Health Serv Res. 2011 Oct 19;11:278. doi: 10.1186/1472-6963-11-278.
A high percentage of cervical cancer cases have not undergone cytological tests within 10 years prior to diagnosis. Different population interventions could improve coverage in the public system, although costs will also increase. The aim of this study was to compare the effectiveness and the costs of three types of population interventions to increase the number of female participants in the screening programmes for cancer of the cervix carried out by Primary Care in four basic health care areas.
METHODS/DESIGN: A cost-effectiveness analysis will be performed from the perspective of public health system including women from 30 to 70 years of age (n = 20,994) with incorrect screening criteria from four basic health care areas in the Valles Occidental, Barcelona, Spain. The patients will be randomly distributed into the control group and the three intervention groups (IG1: invitation letter to participate in the screening; IG2: invitation letter and informative leaflet; IG3: invitation letter, informative leaflet and a phone call reminder) and followed for three years. Clinical effectiveness will be measured by the number of HPV, epithelial lesions and cancer of cervix cases detected. The number of deaths avoided will be secondary measures of effectiveness. The temporal horizon of the analysis will be the life expectancy of the female population in the study. Costs and effectiveness will be discounted at 3%. In addition, univariate and multivariate sensitivity analysis will be carried out.
IG3 is expected to be more cost-effective intervention than IG1 and IG2, with greater detection of HPV infections, epithelial lesions and cancer than other strategies, albeit at a greater cost.
Clinical Trials.gov Identifier NCT01373723.
在诊断前的 10 年内，很大比例的宫颈癌病例未进行细胞学检查。不同的人群干预措施可以提高公共系统的覆盖率，尽管成本也会增加。本研究的目的是比较三种人群干预措施的有效性和成本，以增加参与初级保健在四个基本保健区进行的宫颈癌筛查计划的女性人数。
方法/设计：将从公共卫生系统的角度进行成本效益分析，包括来自西班牙巴塞罗那 Valles Occidental 的四个基本保健区的年龄在 30 至 70 岁之间（n = 20994）的不符合筛查标准的女性。患者将随机分配到对照组和三个干预组（IG1：邀请参加筛查；IG2：邀请信和信息传单；IG3：邀请信、信息传单和电话提醒），并随访三年。临床效果将通过检测到的 HPV、上皮病变和宫颈癌病例数量来衡量。避免死亡的人数将是次要的效果衡量标准。分析的时间范围将是研究中女性人口的预期寿命。成本和效果将贴现 3%。此外，还将进行单变量和多变量敏感性分析。
与 IG1 和 IG2 相比，IG3 预计是更具成本效益的干预措施，与其他策略相比，IG3 能更有效地检测 HPV 感染、上皮病变和宫颈癌，尽管成本更高。
ClinicalTrials.gov 标识符 NCT01373723。
