EVALUATION OF CERVICAL CANCER SCREENING, ANALYZING COST BENEFIT

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The aim of this research is to investigate economic efficiency of cervical cancer screening, comparing cost of mass screening with medical expences.1. Cost of mass screening : This research was done in the area of Saga Central Health Center. The total number of people screened from 1994 to 1996 was 51,458. The number of people who needed closer examinations was 397. Among them cervical cancer was diagnosed in 63 and cervical intraepithelial neoplasia (CJN) was diagnosed in 153. The expenditure of the municipalities for the mass screening during the 3 years adds up to \l66,048,189. If we add cost of close examination to it, the total expenditure is \178,208,189 and cost to diagnose one cancer case is \2,749,336.2. Average medical expenses for each patient who had the screening (49 out of 141 patients stayed in 2 hospitals from 1994 to 1996) was \l, 251,947, and that for 92 patients who didn't have the screening was \2,036,105. Simply the expenses for those who had the screening was \784,158 lower than for those who didn't.3. If mass screening had not been done,(1)Among 153 people who had CIN, 6 would have worsened to invasive cancer, 31 would have worsened to carcinoma in situ.(2) Suppose 100 cases(63 cervical cancer cases plus 37 CIN cases)had not had mass screening, the stages of their disease would have been 39 cases in stage 0, 7 cases in stage Ia, 21 cases in stage Ib, 15 cases in stage II, II cases in stage III and 7 cases in stage IV.(3) Medical expences would have been \162,566,000. Actually, mass screening saved \95,049, O00. But if we add the cost of mass screening to the actual medical expences, the estimated expenses are \78,160,000 smaller.Cervical cancer mass screening can give us early discovery and treatment of the disease, and it also helps us get the treatment at smaller expences. However if we consider the cost of screening it does not reduce social cost.