Cost-effectiveness analysis for cytology and HR-HPV DNA testing in primary cervical screening

OBJECTIVE: To assess whether the combination of cytology test and high risk-human papillomavirus(HR-HPV DNA) testing or the sole cytology screening is more effective and cost-effective in prevention of cervical cancer.METHODS: Potential subjects(6 185 women) were screened using two different preventive strategies including sole thin-prep cytology test(TCT) and HR-HPV DNA testing triage for cytology-positive women taken colposcolpy and biopsy as golden standard.A cost-effectiveness analysis(CEA) was adopted to plot the two different strategies and to compare the screening cost and effectiveness.RESULTS: The incidence of cervical lesions was 9.73% in Beijing area.The prof which CIN Ⅰ,CIN ⅡⅢ and cervical carcinoma in situ were 79.30%,20.16%,0.54% respectively.And the incidence of CIN of the HR-HPV DNA testing triage cytology positive was 75.40%,of which CIN Ⅰ,CIN ⅡⅢ and cervical carcinoma in situ were 62.57%,35.29%,2.14%,respectively.There were significant difference in detection of CIN and CIN ⅡⅢ between the two different strategies(P0.05).The optimal age groups were group 30-44 which could detect more CIN cases.The sole cytology(C/E=$7 041.47) was more cost-effective than the HR-HPV DNA testing combined with cytology(C/E=$3 131.89).CONCLUSION: The sole cytology screening strategy was more cost-effective.HPV-DNA testing can be as a standard in the triage of high-versus low-risk patients which seems more important in group 30-44.