Cost effectiveness of human papillomavirus test of cure after treatment for cervical intraepithelial neoplasia in England: economic analysis from NHS Sentinel Sites Study.
Cost effectiveness of human papillomavirus test of cure after treatment for cervical intraepithelial neoplasia in England: economic analysis from NHS Sentinel Sites Study.
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DOI：
10.1136/bmj.e7086
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发表时间：
2012-10-31
期刊：
影响因子：
--
通讯作者：
Canfell K
中科院分区：
文献类型：
--
作者：
Legood R;Smith M;Lew JB;Walker R;Moss S;Kitchener H;Patnick J;Canfell K
目的评价宫颈上皮内瘤样病变（CIN）治疗后人乳头瘤病毒检测的成本效益。设计经济分析使用马尔可夫建模方法，结合联合收割机成本和流行病学数据从NHS哨兵网站研究与数据从以前的研究治疗后复发率。英国NHS宫颈癌筛查计划。CIN治疗后的干预管理指南包括每年进行10年的细胞学随访，与使用人乳头瘤病毒检测的替代方案相比，以减少治疗后监测的数量。主要结果测量基础CIN 3+病例在10年时避免和每1000名接受治疗的妇女的费用。结果模型预测表明，在观察到的治疗后建议的依从性水平下，仅进行细胞学随访的管理将导致10年内29例复发性CIN 3+的残留病例，每1000名接受治疗的妇女的费用为358 222英镑（440 426欧元; 574 910美元）（折扣）。根据哨兵位点方案，在细胞学阴性的妇女中实施人类乳头瘤病毒治愈检测将避免另外8.4例CIN 3+病例，并使每1000名接受治疗的妇女的费用减少9388英镑。结论与单纯随访细胞学检查相比，人乳头瘤病毒检测的疗效更好，且节省费用。这项评估的结果支持在NHS宫颈筛查计划内全面实施CIN治疗后的人类乳头瘤病毒治愈测试。
Objectives To evaluate the cost effectiveness of human papillomavirus testing after treatment for cervical intraepithelial neoplasia (CIN). Design Economic analysis using a Markov modelling approach to combine cost and epidemiological data from the NHS Sentinel Sites Study with data from previous studies of post-treatment recurrence rates. Setting English NHS Cervical Cancer Screening Programme. Interventions Management guidelines after treatment of CIN involving annual cytology follow-up for 10 years, compared with alternative protocols using the human papillomavirus test to reduce the amount of post-treatment surveillance. Main outcome measures Cases of underlying CIN3+ averted at 10 years and costs per 1000 women treated. Results Model predictions indicated that, at observed levels of compliance with post-treatment recommendations, management with only cytological follow-up would result in 29 residual cases of recurrent CIN3+ by 10 years and would cost £358 222 (€440 426; $574 910) (discounted) per 1000 women treated. Implementation of human papillomavirus test of cure in cytologically negative women according to the sentinel sites protocol would avert an additional 8.4 cases of CIN 3+ and reduce costs by £9388 per 1000 women treated. Conclusions Human papillomavirus test of cure would be more effective and would be cost saving compared with cytology only follow-up. The results of this evaluation support the full scale implementation of human papillomavirus test of cure after treatment of CIN within the NHS Cervical Screening Programme.
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影响因子：
--
作者：
Cecchini, S;Visioli, CB;Ciatto, S
通讯作者：
Ciatto, S
影响因子：
105.7
作者：
Strander, Bjorn;Andersson-Ellstrom, Agneta;Sparen, Par
通讯作者：
Sparen, Par
影响因子：
4.5
作者：
Creighton, Prudence;Lew, Jie-Bin;Canfell, Karen
通讯作者：
Canfell, Karen
影响因子：
8.8
作者：
Sherlaw-Johnson, C;Philips, Z
通讯作者：
Philips, Z
DOI：
10.1111/j.1471-0528.2008.01748.x
发表时间：
2008-07-01
影响因子：
5.8
作者：
Kitchener, H. C.;Walker, P. G.;Cruickshank, M. E.
通讯作者：
Cruickshank, M. E.