Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysis
Background Cervical cancer (CC) is preventable through regular screening and vaccination against human papillomavirus (HPV). However, CC remains a significant public health issue in low-income and middle-income countries (LMICs) like Vietnam, where financial constraints hinder the widespread impleme...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMJ Publishing Group
2025-01-01
|
| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/15/1/e082145.full |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832590916326522880 |
|---|---|
| author | Hien Thu Bui Van Nu Hanh Pham Thang Hong Vu |
| author_facet | Hien Thu Bui Van Nu Hanh Pham Thang Hong Vu |
| author_sort | Hien Thu Bui |
| collection | DOAJ |
| description | Background Cervical cancer (CC) is preventable through regular screening and vaccination against human papillomavirus (HPV). However, CC remains a significant public health issue in low-income and middle-income countries (LMICs) like Vietnam, where financial constraints hinder the widespread implementation of HPV vaccination and screening programmes. Currently, Vietnam lacks both a national CC screening intervention and an HPV vaccination programme for women and girls. To date, cost-effectiveness studies evaluating CC screening methods in Vietnam remain limited.Objectives To evaluate the cost-effectiveness of two CC screening strategies for Vietnamese women aged 25–55 years: (1) cotesting combining cytology and HPV testing conducted three times at 5 year intervals (intervention) and (2) cytology-based screening conducted five times at 2 year intervals (comparator). The objective is to provide evidence to inform policy and clinical practice in Vietnam.Design Cost-effectiveness analysis using a Markov model with 1 year cycles to simulate the natural progression of CC.Setting The Vietnamese healthcare system, modelled from the provider’s perspective, with parameters adapted to the local context through expert consultations.Participants A simulated cohort of Vietnamese women aged 25–55 years.Interventions The intervention involved cotesting (cytology and HPV testing) three times at 5 year intervals. The comparator was cytology-based screening conducted five times at 2 year intervals.Primary and secondary outcome measures The primary outcome measure was quality-adjusted life years (QALYs). Costs and cost-effectiveness ratios were assessed using Vietnam’s gross domestic product (GDP) per capita as the cost-effectiveness threshold (1–3 times GDP per capita). Sensitivity analyses (one-way deterministic and probabilistic) were conducted to account for uncertainties.Results The cotesting strategy was less effective and more costly than cytology-based screening across all age groups. Cotesting resulted in higher costs and fewer QALYs than the comparator. Probabilistic sensitivity analyses confirmed that cotesting was not cost-effective under current conditions in Vietnam.Conclusions Cytology-based screening conducted five times at 2 year intervals is a more cost-effective option for CC screening in Vietnamese women aged 25–55 years. The cotesting strategy cannot be recommended due to its higher cost and lower effectiveness. |
| format | Article |
| id | doaj-art-cdcfc4e98e5f47d4bbe9954a0da9f36d |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-cdcfc4e98e5f47d4bbe9954a0da9f36d2025-01-23T06:55:09ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2023-082145Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysisHien Thu Bui0Van Nu Hanh Pham1Thang Hong Vu2Center for Population Health Science, Hanoi University of Public Health, Hanoi, VietnamDepartment of Pharmaceutical Administration and Pharmacoeconomics, Hanoi University of Pharmacy, Hanoi, VietnamDepartment of Oncology, Hanoi Medical University, Hanoi, VietnamBackground Cervical cancer (CC) is preventable through regular screening and vaccination against human papillomavirus (HPV). However, CC remains a significant public health issue in low-income and middle-income countries (LMICs) like Vietnam, where financial constraints hinder the widespread implementation of HPV vaccination and screening programmes. Currently, Vietnam lacks both a national CC screening intervention and an HPV vaccination programme for women and girls. To date, cost-effectiveness studies evaluating CC screening methods in Vietnam remain limited.Objectives To evaluate the cost-effectiveness of two CC screening strategies for Vietnamese women aged 25–55 years: (1) cotesting combining cytology and HPV testing conducted three times at 5 year intervals (intervention) and (2) cytology-based screening conducted five times at 2 year intervals (comparator). The objective is to provide evidence to inform policy and clinical practice in Vietnam.Design Cost-effectiveness analysis using a Markov model with 1 year cycles to simulate the natural progression of CC.Setting The Vietnamese healthcare system, modelled from the provider’s perspective, with parameters adapted to the local context through expert consultations.Participants A simulated cohort of Vietnamese women aged 25–55 years.Interventions The intervention involved cotesting (cytology and HPV testing) three times at 5 year intervals. The comparator was cytology-based screening conducted five times at 2 year intervals.Primary and secondary outcome measures The primary outcome measure was quality-adjusted life years (QALYs). Costs and cost-effectiveness ratios were assessed using Vietnam’s gross domestic product (GDP) per capita as the cost-effectiveness threshold (1–3 times GDP per capita). Sensitivity analyses (one-way deterministic and probabilistic) were conducted to account for uncertainties.Results The cotesting strategy was less effective and more costly than cytology-based screening across all age groups. Cotesting resulted in higher costs and fewer QALYs than the comparator. Probabilistic sensitivity analyses confirmed that cotesting was not cost-effective under current conditions in Vietnam.Conclusions Cytology-based screening conducted five times at 2 year intervals is a more cost-effective option for CC screening in Vietnamese women aged 25–55 years. The cotesting strategy cannot be recommended due to its higher cost and lower effectiveness.https://bmjopen.bmj.com/content/15/1/e082145.full |
| spellingShingle | Hien Thu Bui Van Nu Hanh Pham Thang Hong Vu Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysis BMJ Open |
| title | Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysis |
| title_full | Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysis |
| title_fullStr | Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysis |
| title_full_unstemmed | Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysis |
| title_short | Cervical cancer screening by cotesting method for Vietnamese women 25–55 years old: a cost-effectiveness analysis |
| title_sort | cervical cancer screening by cotesting method for vietnamese women 25 55 years old a cost effectiveness analysis |
| url | https://bmjopen.bmj.com/content/15/1/e082145.full |
| work_keys_str_mv | AT hienthubui cervicalcancerscreeningbycotestingmethodforvietnamesewomen2555yearsoldacosteffectivenessanalysis AT vannuhanhpham cervicalcancerscreeningbycotestingmethodforvietnamesewomen2555yearsoldacosteffectivenessanalysis AT thanghongvu cervicalcancerscreeningbycotestingmethodforvietnamesewomen2555yearsoldacosteffectivenessanalysis |