Health economics analysis of cervical cancer screening

INTRODUCTION: To reduce the high mortality rate of cervical cancer there are organized, nation-wide mass-screening programmes. AIM: To assess the screening rate, the cost of screening and treatment and to calculate the expected epidemiological and economic gain and cost-effectiveness of mass-screening programme. METHODS: The data derive from the financial database of the National Health Insurance Fund of Hungary from 2001. To assess the screening rate the authors used the code "No. 29601 cytological examination for screening" of out-patient care. The cost of treatment includes the cost of out-patient care, the acute and chronic inpatient care, the subsidies of medicines' prices and the expenditure on disability to work (including sickness-pay). The expected benefits of the screening programme were modelled with changing the screening interval. RESULTS: The screening rates for 1999, 2000 and 2001 were 14.5%, 16.2% and 15.6% respectively, while the 3 year screening rate for 1999-2001 were 35.7%. The cost of treatment of cervical cancer were around 1 billion Hungarian forint in 2001. The cost of one life saved according to the current screening strategy was 16.6 million Hungarian forints (57.792 USD) with a successful screening programme, while with a less successful program it was 33.8 million Hungarian forint (118.093 USD). The cost of one life year gained according to the current screening strategy was 0.7 million Hungarian forints (2.513 USD) with a successful screening programme, while with a less successful program it was 1.5 million Hungarian forint (5.134 USD). CONCLUSION: It is important to increase the screening rate. With increasing the screening interval for women aged between 25-65 from 1 year to 2 or 3 years, it improves the cost-effectiveness of screening programme.