Levin & Morgan LLC, Bethesda, USA.
Ministry of Health, Dodoma, United Republic of Tanzania.
BMC Med. 2022 Nov 1;20(1):384. doi: 10.1186/s12916-022-02576-x.
The World Health Organization (WHO) has developed a costing tool, the Cervical Cancer Prevention and Control Costing (C4P) tool, to estimate the comprehensive cost of cervical cancer primary, secondary and tertiary prevention in low- and middle-income countries. The tool was piloted in the United Republic of Tanzania, a country with a high incidence of cervical cancer with 62.5 cases per 100,000 women in 2020. This paper presents the costing tool methods as well as the results from the pilot in Tanzania.
The C4P tool estimates the incremental costs of cervical cancer prevention and control programmes. It estimates the financial (monetary costs to the government) and economic costs (opportunity costs). For the pilot, the study team collected data on costs and programme assumptions for human papillomavirus (HPV) vaccination of 14-year-old girls and scaling up of cervical cancer screening (visual inspection with acetic acid and HPV-DNA testing) and treatment for women for 2020-2024. Assumptions were made on how vaccination coverage would increase over the 5 years as well as developing additional screening and treatment capacity through health personnel training and infrastructure strengthening.
The total financial and economic costs of the comprehensive programme during 2020-2024 are projected to be US$68 million and US$124 million, respectively. The financial and economic costs of a fully immunized girl with HPV vaccine are estimated to be US$6.68 and US$17.31, respectively, while the costs per woman screened for cervical cancer are, on average, US$4.02 and US$5.83, respectively; US$6.44 and US$9.37 for pre-cancer treatment, respectively; and US$101 and US$107 for diagnosis of invasive cancer, respectively. The cost of treating and managing invasive cancer range from US$7.05 and US$7.83 for outpatient palliative care to US$800.21 and US$893.80 for radiotherapy, respectively.
The C4P costing tool can assist national cervical cancer programmes to estimate monetary resources needed as well as opportunity costs of reducing national cervical cancer incidence through primary, secondary and tertiary prevention.
世界卫生组织（世卫组织）开发了一种成本核算工具，即宫颈癌预防和控制成本核算（C4P）工具，用于估算中低收入国家宫颈癌初级、二级和三级预防的综合成本。该工具已在坦桑尼亚联合共和国进行了试点，该国宫颈癌发病率高，2020 年每 10 万名妇女中有 62.5 例宫颈癌。本文介绍了该工具的成本核算方法以及在坦桑尼亚的试点结果。
C4P 工具估计宫颈癌预防和控制规划的增量成本。它估计财政成本（政府的货币成本）和经济成本（机会成本）。在试点中，研究团队收集了 2020-2024 年 14 岁女孩人乳头瘤病毒（HPV）疫苗接种以及扩大宫颈癌筛查（醋酸视觉检查和 HPV-DNA 检测）和为妇女提供治疗的成本数据。假设在 5 年内疫苗接种覆盖率将如何增加，以及通过卫生人员培训和基础设施建设增加额外的筛查和治疗能力。
2020-2024 年期间，全面规划的总财政和经济成本预计分别为 6800 万美元和 1.24 亿美元。接种 HPV 疫苗的完全免疫女孩的财政和经济成本估计分别为 6.68 美元和 17.31 美元，而宫颈癌筛查的每位妇女平均成本分别为 4.02 美元和 5.83 美元；分别用于癌前治疗的成本为 6.44 美元和 9.37 美元；分别用于诊断浸润性癌症的成本为 101 美元和 107 美元。治疗和管理浸润性癌症的成本范围从门诊姑息治疗的 7.05 美元和 7.83 美元到放射治疗的 800.21 美元和 893.80 美元不等。
C4P 成本核算工具可以帮助国家宫颈癌规划估算通过初级、二级和三级预防降低国家宫颈癌发病率所需的货币资源以及机会成本。
