Ramos-Barrón M Á, Vázquez-Rodríguez J A, García-Garrido A B
Servicio de Urgencias de Atención Primaria de Torrelavega, Gerencia de Atención Primaria, Servicio Cántabro de Salud, Torrelavega, Cantabria, España.
Servicio de Oncología Radioterápica, Hospital Universitario Marqués de Valdecilla, Servicio Cántabro de Salud, Santander, Cantabria, España.
Semergen. 2014 Sep;40(6):296-304. doi: 10.1016/j.semerg.2013.11.006. Epub 2014 Feb 16.
Cervical cancer is the second most common cancer worldwide in women, with an annual mortality of 3.6 per 100.000 women in Spain. An opportunistic screening protocol is currently being developed in Cantabria. The objective of the study is to propose a population-based screening program in Cantabria and assess its cost-benefits.
The population-based program design has been carried out according to the description of the natural course of cervical cancer and its incidence and mortality in Cantabria during 2000-2009. There have been some proposals to increase participation in the program and to evaluate its quality. Costs and benefits (direct and indirect) have been analyzed in several scenarios by modifying the frequency of tests (3-5 years), the age at which the program can be accessed (21, 25 or 30 years), the coverage of the program (60-80%), and discount rates (0-3-6%).
A program carried out with coverage of 80% and tests performed every 3 years generates annual costs of €893.000 (discount rate of 3%) compared to the current opportunistic protocol. Scenarios with tests performed every 5 years generate an annual benefit higher than €618.000, depending on the age of accessing the program.
Scenarios with coverage lower than 60% or with women over 30 years old having access to the program are not of interest because of the lower health benefits. However, performing tests every 5 years is more economically advantageous than every 3 years, with similar health benefits.
