Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA

• Published in: Cancer causes & control 2020-07, Vol.31 (7), p.691-702
• Main Authors: Pollack, Lisa M., Ekwueme, Donatus U., Hung, Mei-Chuan, Miller, Jacqueline W., Chang, Su-Hsin
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Biomedical and Life Sciences; Biomedicine; Black or African American - statistics & numerical data; Breast cancer; Breast Neoplasms - epidemiology; Cancer; Cancer Research; Cancer screening; Cervical cancer; Cervix; Early Detection of Cancer - economics; Early Detection of Cancer - methods; Early Detection of Cancer - statistics & numerical data; Epidemiology; Female; Health risk assessment; Hematology; Humans; Income; Low income groups; Medical screening; Middle Aged; Models, Statistical; Oncology; Original Paper; Public Health; Quality-Adjusted Life Years; Registries; SEER Program; Surveys and Questionnaires; United States - epidemiology; Uterine Cervical Neoplasms - diagnosis; Uterine Cervical Neoplasms - epidemiology; Uterine Cervical Neoplasms - pathology; Womens health; Young Adult
• ISSN: 0957-5243; 1573-7225
• DOI: 10.1007/s10552-020-01314-z

Purpose The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free cervical cancer screening to low-income women. This study estimated the health benefits gained in terms of life years (LYs) saved and quality-adjusted life years (QALYs) gained if cervical cancer screening by the NBCCEDP increased to reach more eligible women. Methods Data from Surveillance, Epidemiology, and End Results, NBCCEDP, and Medical Expenditure Panel Surveys were used. LYs saved and QALYs gained/100,000 women were estimated using modeling methods. They were used to predict additional health benefits gained if screening by the NBCCEDP increased from 6.5% up to 10–25% of the eligible women. Results Overall, per 100,000 women screened by the NBCCEDP, 1,731 LYs were saved and 1,608 QALYs were gained. For white women, 1,926 LYs were saved and 1,780 QALYs were gained/100,000 women screened by the NBCCEDP. For black women, 1,506 LYs were saved and 1,300 QALYs were gained/100,000 women screened. If the proportion of eligible women screened by the NBCCEDP increased to 10–25%, the estimated health benefits would range from 6,626–34,896 LYs saved and 6,153–32,407 QALYs gained. Conclusions The reported estimates emphasize the value of cervical cancer screening program by extending LE in low-income women. Further, it demonstrates that screening a higher percentage of eligible women in the NBCCEDP may yield more health benefits.