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The Cost-Effectiveness Analysis of Cervical Cancer Screening Using a Systematic Invitation System in Lithuania
In Lithuania, cytological screening of cervical cancer (CC) is largely opportunistic. Absence of standardized systematic invitation practice might be the reason for low participation rates. The study aimed to assess the cost-effectiveness of systematic invitation approach in CC screening programme f...
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| Published in: | International journal of environmental research and public health 2019-12, Vol.16 (24), p.5035 |
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| cited_by | cdi_FETCH-LOGICAL-c418t-55cd697a856e7f8bef5cfc3edb70d9553be2868728995e7575d190851b5235243 |
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| cites | cdi_FETCH-LOGICAL-c418t-55cd697a856e7f8bef5cfc3edb70d9553be2868728995e7575d190851b5235243 |
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| container_issue | 24 |
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| container_title | International journal of environmental research and public health |
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| creator | Paulauskiene, Justina Stelemekas, Mindaugas Ivanauskiene, Rugile Petkeviciene, Janina |
| description | In Lithuania, cytological screening of cervical cancer (CC) is largely opportunistic. Absence of standardized systematic invitation practice might be the reason for low participation rates. The study aimed to assess the cost-effectiveness of systematic invitation approach in CC screening programme from the perspective of a healthcare provider. A decision tree was used to compare an opportunistic invitation by a family doctor, a personal postal invitation letter with appointment time and place, and a personal postal invitation letter with appointment time and place with one reminder letter. Cost-effectiveness was defined as an incremental cost-effectiveness ratio (ICER) per one additionally screened woman and per one additional abnormal Pap smear test detected. The ICER of one personal postal invitation letter was €9.67 per one additionally screened woman and €55.21 per one additional abnormal Pap smear test detected in comparison with the current screening practice. The ICER of a personal invitation letter with an additional reminder letter compared to one invitation letter was €13.47 and €86.88 respectively. Conclusions: A personal invitation letter approach is more effective in increasing the participation rate in CC screening and the number of detected abnormal Pap smears; however, it incurs additional expenses compared with current invitation practice. |
| doi_str_mv | 10.3390/ijerph16245035 |
| format | article |
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Absence of standardized systematic invitation practice might be the reason for low participation rates. The study aimed to assess the cost-effectiveness of systematic invitation approach in CC screening programme from the perspective of a healthcare provider. A decision tree was used to compare an opportunistic invitation by a family doctor, a personal postal invitation letter with appointment time and place, and a personal postal invitation letter with appointment time and place with one reminder letter. Cost-effectiveness was defined as an incremental cost-effectiveness ratio (ICER) per one additionally screened woman and per one additional abnormal Pap smear test detected. The ICER of one personal postal invitation letter was €9.67 per one additionally screened woman and €55.21 per one additional abnormal Pap smear test detected in comparison with the current screening practice. The ICER of a personal invitation letter with an additional reminder letter compared to one invitation letter was €13.47 and €86.88 respectively. Conclusions: A personal invitation letter approach is more effective in increasing the participation rate in CC screening and the number of detected abnormal Pap smears; however, it incurs additional expenses compared with current invitation practice.</description><identifier>ISSN: 1660-4601</identifier><identifier>ISSN: 1661-7827</identifier><identifier>EISSN: 1660-4601</identifier><identifier>DOI: 10.3390/ijerph16245035</identifier><identifier>PMID: 31835649</identifier><language>eng</language><publisher>Switzerland: MDPI AG</publisher><subject>Adult ; Cervical cancer ; Cervix ; Clinical trials ; Correspondence as Topic ; Cost analysis ; Cost-Benefit Analysis ; Costs ; Early Detection of Cancer - economics ; Early Detection of Cancer - methods ; Family Practice - economics ; Family Practice - methods ; Female ; Health ; Health Care Costs - statistics & numerical data ; Health insurance ; Health sciences ; Hospitals ; Humans ; Insurance ; Lithuania ; Medical screening ; Methods ; Middle Aged ; Mortality ; Papanicolaou Test ; Participation ; Patient Acceptance of Health Care - statistics & numerical data ; Physician-Patient Relations ; Quality control ; Uterine Cervical Neoplasms - diagnosis ; Uterine Cervical Neoplasms - economics ; Uterine Cervical Neoplasms - psychology ; Vaginal Smears - economics ; Womens health</subject><ispartof>International journal of environmental research and public health, 2019-12, Vol.16 (24), p.5035</ispartof><rights>2019. This work is licensed under http://creativecommons.org/licenses/by/3.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2019 by the authors. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-55cd697a856e7f8bef5cfc3edb70d9553be2868728995e7575d190851b5235243</citedby><cites>FETCH-LOGICAL-c418t-55cd697a856e7f8bef5cfc3edb70d9553be2868728995e7575d190851b5235243</cites><orcidid>0000-0002-3953-8655 ; 0000-0002-2040-6900</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.proquest.com/docview/2329668554/fulltextPDF?pq-origsite=primo$$EPDF$$P50$$Gproquest$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/2329668554?pq-origsite=primo$$EHTML$$P50$$Gproquest$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,25731,27901,27902,36989,36990,44566,53766,53768,74869</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31835649$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Paulauskiene, Justina</creatorcontrib><creatorcontrib>Stelemekas, Mindaugas</creatorcontrib><creatorcontrib>Ivanauskiene, Rugile</creatorcontrib><creatorcontrib>Petkeviciene, Janina</creatorcontrib><title>The Cost-Effectiveness Analysis of Cervical Cancer Screening Using a Systematic Invitation System in Lithuania</title><title>International journal of environmental research and public health</title><addtitle>Int J Environ Res Public Health</addtitle><description>In Lithuania, cytological screening of cervical cancer (CC) is largely opportunistic. Absence of standardized systematic invitation practice might be the reason for low participation rates. The study aimed to assess the cost-effectiveness of systematic invitation approach in CC screening programme from the perspective of a healthcare provider. A decision tree was used to compare an opportunistic invitation by a family doctor, a personal postal invitation letter with appointment time and place, and a personal postal invitation letter with appointment time and place with one reminder letter. Cost-effectiveness was defined as an incremental cost-effectiveness ratio (ICER) per one additionally screened woman and per one additional abnormal Pap smear test detected. The ICER of one personal postal invitation letter was €9.67 per one additionally screened woman and €55.21 per one additional abnormal Pap smear test detected in comparison with the current screening practice. The ICER of a personal invitation letter with an additional reminder letter compared to one invitation letter was €13.47 and €86.88 respectively. Conclusions: A personal invitation letter approach is more effective in increasing the participation rate in CC screening and the number of detected abnormal Pap smears; however, it incurs additional expenses compared with current invitation practice.</description><subject>Adult</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Clinical trials</subject><subject>Correspondence as Topic</subject><subject>Cost analysis</subject><subject>Cost-Benefit Analysis</subject><subject>Costs</subject><subject>Early Detection of Cancer - economics</subject><subject>Early Detection of Cancer - methods</subject><subject>Family Practice - economics</subject><subject>Family Practice - methods</subject><subject>Female</subject><subject>Health</subject><subject>Health Care Costs - statistics & numerical data</subject><subject>Health insurance</subject><subject>Health sciences</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Insurance</subject><subject>Lithuania</subject><subject>Medical screening</subject><subject>Methods</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Papanicolaou Test</subject><subject>Participation</subject><subject>Patient Acceptance of Health Care - statistics & numerical data</subject><subject>Physician-Patient Relations</subject><subject>Quality control</subject><subject>Uterine Cervical Neoplasms - diagnosis</subject><subject>Uterine Cervical Neoplasms - economics</subject><subject>Uterine Cervical Neoplasms - psychology</subject><subject>Vaginal Smears - economics</subject><subject>Womens health</subject><issn>1660-4601</issn><issn>1661-7827</issn><issn>1660-4601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>PIMPY</sourceid><recordid>eNpdkUFr3DAQhUVpadK01x6LoJdenEqWR5YuhWDSNrDQQ5KzkOVxVotX2krywv77eMk2JL2MhtE3b0Z6hHzm7FIIzb77Dabdmsu6ASbgDTnnUrKqkYy_fZGfkQ85bxgTqpH6PTkTXAmQjT4n4W6NtIu5VNfjiK74PQbMmV4FOx2yzzSOtMO0985OtLPBYaK3LiEGHx7ofT5GS28PueDWFu_oTdj7smQxnKrUB7ryZT3b4O1H8m60U8ZPp_OC3P-8vut-V6s_v266q1XlGq5KBeAGqVurQGI7qh5HcKMTOPQtGzSA6LFWUrW10hqwhRYGrpkC3kMtoG7EBfnxpLub-y0ODkNJdjK75Lc2HUy03ry-CX5tHuLeSA0MJFsEvp0EUvw7Yy5m67PDabIB45xNLYSsl0lcL-jX_9BNnNPyf0eq1lIqgONGl0-USzHnhOPzMpyZo5XmtZVLw5eXT3jG_3knHgGVhJv9</recordid><startdate>20191211</startdate><enddate>20191211</enddate><creator>Paulauskiene, Justina</creator><creator>Stelemekas, Mindaugas</creator><creator>Ivanauskiene, Rugile</creator><creator>Petkeviciene, Janina</creator><general>MDPI AG</general><general>MDPI</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-3953-8655</orcidid><orcidid>https://orcid.org/0000-0002-2040-6900</orcidid></search><sort><creationdate>20191211</creationdate><title>The Cost-Effectiveness Analysis of Cervical Cancer Screening Using a Systematic Invitation System in Lithuania</title><author>Paulauskiene, Justina ; Stelemekas, Mindaugas ; Ivanauskiene, Rugile ; Petkeviciene, Janina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-55cd697a856e7f8bef5cfc3edb70d9553be2868728995e7575d190851b5235243</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Adult</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Clinical trials</topic><topic>Correspondence as Topic</topic><topic>Cost analysis</topic><topic>Cost-Benefit Analysis</topic><topic>Costs</topic><topic>Early Detection of Cancer - economics</topic><topic>Early Detection of Cancer - methods</topic><topic>Family Practice - economics</topic><topic>Family Practice - methods</topic><topic>Female</topic><topic>Health</topic><topic>Health Care Costs - statistics & numerical data</topic><topic>Health insurance</topic><topic>Health sciences</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Insurance</topic><topic>Lithuania</topic><topic>Medical screening</topic><topic>Methods</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Papanicolaou Test</topic><topic>Participation</topic><topic>Patient Acceptance of Health Care - statistics & numerical data</topic><topic>Physician-Patient Relations</topic><topic>Quality control</topic><topic>Uterine Cervical Neoplasms - diagnosis</topic><topic>Uterine Cervical Neoplasms - economics</topic><topic>Uterine Cervical Neoplasms - psychology</topic><topic>Vaginal Smears - economics</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Paulauskiene, Justina</creatorcontrib><creatorcontrib>Stelemekas, Mindaugas</creatorcontrib><creatorcontrib>Ivanauskiene, Rugile</creatorcontrib><creatorcontrib>Petkeviciene, Janina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>International journal of environmental research and public health</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Paulauskiene, Justina</au><au>Stelemekas, Mindaugas</au><au>Ivanauskiene, Rugile</au><au>Petkeviciene, Janina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Cost-Effectiveness Analysis of Cervical Cancer Screening Using a Systematic Invitation System in Lithuania</atitle><jtitle>International journal of environmental research and public health</jtitle><addtitle>Int J Environ Res Public Health</addtitle><date>2019-12-11</date><risdate>2019</risdate><volume>16</volume><issue>24</issue><spage>5035</spage><pages>5035-</pages><issn>1660-4601</issn><issn>1661-7827</issn><eissn>1660-4601</eissn><abstract>In Lithuania, cytological screening of cervical cancer (CC) is largely opportunistic. Absence of standardized systematic invitation practice might be the reason for low participation rates. The study aimed to assess the cost-effectiveness of systematic invitation approach in CC screening programme from the perspective of a healthcare provider. A decision tree was used to compare an opportunistic invitation by a family doctor, a personal postal invitation letter with appointment time and place, and a personal postal invitation letter with appointment time and place with one reminder letter. Cost-effectiveness was defined as an incremental cost-effectiveness ratio (ICER) per one additionally screened woman and per one additional abnormal Pap smear test detected. The ICER of one personal postal invitation letter was €9.67 per one additionally screened woman and €55.21 per one additional abnormal Pap smear test detected in comparison with the current screening practice. The ICER of a personal invitation letter with an additional reminder letter compared to one invitation letter was €13.47 and €86.88 respectively. Conclusions: A personal invitation letter approach is more effective in increasing the participation rate in CC screening and the number of detected abnormal Pap smears; however, it incurs additional expenses compared with current invitation practice.</abstract><cop>Switzerland</cop><pub>MDPI AG</pub><pmid>31835649</pmid><doi>10.3390/ijerph16245035</doi><orcidid>https://orcid.org/0000-0002-3953-8655</orcidid><orcidid>https://orcid.org/0000-0002-2040-6900</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Cervical cancer Cervix Clinical trials Correspondence as Topic Cost analysis Cost-Benefit Analysis Costs Early Detection of Cancer - economics Early Detection of Cancer - methods Family Practice - economics Family Practice - methods Female Health Health Care Costs - statistics & numerical data Health insurance Health sciences Hospitals Humans Insurance Lithuania Medical screening Methods Middle Aged Mortality Papanicolaou Test Participation Patient Acceptance of Health Care - statistics & numerical data Physician-Patient Relations Quality control Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - economics Uterine Cervical Neoplasms - psychology Vaginal Smears - economics Womens health |
| title | The Cost-Effectiveness Analysis of Cervical Cancer Screening Using a Systematic Invitation System in Lithuania |
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