High-risk human papillomavirus testing for underscreened populations: cost-effectiveness and affordability in three country settings
Abstract Background The high-risk human papillomavirus (hrHPV)-based screening recommended by the World Health Organization is expected to lead to worldwide reduction of the cervical cancer burden, but the countries burdened most by cervical cancer also struggle with the costs of transitioning to th...
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2025-07-01
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| Online Access: | https://doi.org/10.1186/s12889-025-23791-0 |
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| author | Marat Sultanov Geertruida H. de Bock Jaap A.R. Koot Janine de Zeeuw Marcel J.W. Greuter Fengming Pan Jelle Stekelenburg Jogchum J. Beltman Marlieke de Fouw Carolyn Nakisige Johnblack K. Kabukye Ezra Anecho Naheed Nazrul Mosamat U. Kulsum Aminur Rahman Marek Majdan Juliana Melichová Jaroslava Sokolová Jurjen van der Schans |
| author_facet | Marat Sultanov Geertruida H. de Bock Jaap A.R. Koot Janine de Zeeuw Marcel J.W. Greuter Fengming Pan Jelle Stekelenburg Jogchum J. Beltman Marlieke de Fouw Carolyn Nakisige Johnblack K. Kabukye Ezra Anecho Naheed Nazrul Mosamat U. Kulsum Aminur Rahman Marek Majdan Juliana Melichová Jaroslava Sokolová Jurjen van der Schans |
| author_sort | Marat Sultanov |
| collection | DOAJ |
| description | Abstract Background The high-risk human papillomavirus (hrHPV)-based screening recommended by the World Health Organization is expected to lead to worldwide reduction of the cervical cancer burden, but the countries burdened most by cervical cancer also struggle with the costs of transitioning to this approach. Country-specific evaluations are needed to inform policymakers on implementation of hrHPV-based screening for their setting. Following initial implementation in Uganda, Bangladesh and Slovakia focused on underscreened women in the PRESCRIP-TEC project, we investigated the potential cost-effectiveness and affordability of hrHPV-based screening strategies. Methods Country-specific model-based cost-effectiveness and budget impact analyses were conducted for the three countries, comparing the PRESCRIP-TEC strategy with the existing screening strategy in each setting. Data from initial project implementation informed the relevant model parameters. Results The PRESCRIP-TEC strategy resulted in disability-adjusted life year (DALY) gains in all three countries. The cervical cancer incidence rate was reduced by a third for Uganda, 15% for Bangladesh and 11% for Slovakia. The incremental cost-effectiveness ratios were UGX 0.56 million per DALY for Uganda (I$ 475), BDT 76 thousand per DALY for Bangladesh (I$ 1698) and EUR 1782 (I$ 3637) per DALY for Slovakia. Substantial additional funding will be required to enable implementation, particularly in relation to the initial start-up costs. Conclusions The provided estimates can serve to inform policymakers and researchers in the context of implementing hrHPV-based screening in diverse settings. |
| format | Article |
| id | doaj-art-d815526710ff4e15bcb6c9f588eee6b9 |
| institution | Kabale University |
| issn | 1471-2458 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Public Health |
| spelling | doaj-art-d815526710ff4e15bcb6c9f588eee6b92025-08-20T03:46:28ZengBMCBMC Public Health1471-24582025-07-0125111110.1186/s12889-025-23791-0High-risk human papillomavirus testing for underscreened populations: cost-effectiveness and affordability in three country settingsMarat Sultanov0Geertruida H. de Bock1Jaap A.R. Koot2Janine de Zeeuw3Marcel J.W. Greuter4Fengming Pan5Jelle Stekelenburg6Jogchum J. Beltman7Marlieke de Fouw8Carolyn Nakisige9Johnblack K. Kabukye10Ezra Anecho11Naheed Nazrul12Mosamat U. Kulsum13Aminur Rahman14Marek Majdan15Juliana Melichová16Jaroslava Sokolová17Jurjen van der Schans18Department of Health Sciences, Global Health Unit, University Medical Center Groningen, University of GroningenDepartment of Epidemiology, University Medical Center Groningen, University of GroningenDepartment of Health Sciences, Global Health Unit, University Medical Center Groningen, University of GroningenDepartment of Health Sciences, Global Health Unit, University Medical Center Groningen, University of GroningenDepartment of Radiology, University Medical Center Groningen, University of GroningenDepartment of Epidemiology, University Medical Center Groningen, University of GroningenDepartment of Health Sciences, Global Health Unit, University Medical Center Groningen, University of GroningenDepartment of Gynecology, Leiden University Medical Center, Leiden UniversityDepartment of Gynecology, Leiden University Medical Center, Leiden UniversityUganda Cancer InstituteUganda Cancer InstituteUganda Cancer InstituteFriendship NGOFriendship NGOInternational Centre for Diarrhoeal Disease Research (icddr,b)Department of Public Health, Faculty of Health Care and Social Work, Institute for Global Health and Epidemiology, Trnava UniversityDepartment of Public Health, Faculty of Health Care and Social Work, Institute for Global Health and Epidemiology, Trnava UniversityDepartment of Laboratory Medicine, Faculty of Health Care and Social Work, Center for Microbiology and Infection Prevention, Trnava UniversityDepartment of Health Sciences, Global Health Unit, University Medical Center Groningen, University of GroningenAbstract Background The high-risk human papillomavirus (hrHPV)-based screening recommended by the World Health Organization is expected to lead to worldwide reduction of the cervical cancer burden, but the countries burdened most by cervical cancer also struggle with the costs of transitioning to this approach. Country-specific evaluations are needed to inform policymakers on implementation of hrHPV-based screening for their setting. Following initial implementation in Uganda, Bangladesh and Slovakia focused on underscreened women in the PRESCRIP-TEC project, we investigated the potential cost-effectiveness and affordability of hrHPV-based screening strategies. Methods Country-specific model-based cost-effectiveness and budget impact analyses were conducted for the three countries, comparing the PRESCRIP-TEC strategy with the existing screening strategy in each setting. Data from initial project implementation informed the relevant model parameters. Results The PRESCRIP-TEC strategy resulted in disability-adjusted life year (DALY) gains in all three countries. The cervical cancer incidence rate was reduced by a third for Uganda, 15% for Bangladesh and 11% for Slovakia. The incremental cost-effectiveness ratios were UGX 0.56 million per DALY for Uganda (I$ 475), BDT 76 thousand per DALY for Bangladesh (I$ 1698) and EUR 1782 (I$ 3637) per DALY for Slovakia. Substantial additional funding will be required to enable implementation, particularly in relation to the initial start-up costs. Conclusions The provided estimates can serve to inform policymakers and researchers in the context of implementing hrHPV-based screening in diverse settings.https://doi.org/10.1186/s12889-025-23791-0Cervical cancerScreeningCost-effectivenessBudget impactHigh-risk human papillomavirusEconomic evaluation |
| spellingShingle | Marat Sultanov Geertruida H. de Bock Jaap A.R. Koot Janine de Zeeuw Marcel J.W. Greuter Fengming Pan Jelle Stekelenburg Jogchum J. Beltman Marlieke de Fouw Carolyn Nakisige Johnblack K. Kabukye Ezra Anecho Naheed Nazrul Mosamat U. Kulsum Aminur Rahman Marek Majdan Juliana Melichová Jaroslava Sokolová Jurjen van der Schans High-risk human papillomavirus testing for underscreened populations: cost-effectiveness and affordability in three country settings BMC Public Health Cervical cancer Screening Cost-effectiveness Budget impact High-risk human papillomavirus Economic evaluation |
| title | High-risk human papillomavirus testing for underscreened populations: cost-effectiveness and affordability in three country settings |
| title_full | High-risk human papillomavirus testing for underscreened populations: cost-effectiveness and affordability in three country settings |
| title_fullStr | High-risk human papillomavirus testing for underscreened populations: cost-effectiveness and affordability in three country settings |
| title_full_unstemmed | High-risk human papillomavirus testing for underscreened populations: cost-effectiveness and affordability in three country settings |
| title_short | High-risk human papillomavirus testing for underscreened populations: cost-effectiveness and affordability in three country settings |
| title_sort | high risk human papillomavirus testing for underscreened populations cost effectiveness and affordability in three country settings |
| topic | Cervical cancer Screening Cost-effectiveness Budget impact High-risk human papillomavirus Economic evaluation |
| url | https://doi.org/10.1186/s12889-025-23791-0 |
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