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Economic evaluation of thermal ablation compared to cryotherapy and loop diathermy in a screen-and-treat approach to cervical cancer, Zambia
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Economic evaluation of thermal ablation compared to cryotherapy and loop diathermy in a screen-and-treat approach to cervical cancer, Zambia
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Journal Article
Economic evaluation of thermal ablation compared to cryotherapy and loop diathermy in a screen-and-treat approach to cervical cancer, Zambia
2025
Overview
To estimate the financial and economic costs and the cost-effectiveness of thermal ablation compared to cryotherapy and loop diathermy within a screen-and-treat approach to cervical cancer screening in Zambia.
We analysed costs within a randomized controlled trial in which women eligible for ablative treatment after cervical cancer screening were assigned to one of three treatment arms: thermal ablation, cryotherapy or loop diathermy. We used a microcosting approach to calculate programme, personnel, equipment and consumable costs for two groups: women treated without follow-up (screened-and-treated) and women who completed follow-up (follow-up-completed). We also estimated trial costs and projected costs if the screen-and-treat approach were to be integrated into routine cervical cancer services. To assess how cost-effective the treatments were, we used a decision tree model.
Out of the 3124 women who were screened-and-treated, 2386 (76.4%) completed follow-up. In the trial scenario, costs for thermal ablation were lower than cryotherapy and loop diathermy, both per screened-and-treated woman (39.6 United States dollars (US$) versus US$ 42.3 and US$ 50.6, respectively) and per follow-up-completed woman (US$ 55.1 versus US$ 57.9 and US$ 66.2, respectively). In the routine scenario, costs for thermal ablation were also lower than for other treatments (US$ 12.7 versus US$ 15.6 and US$ 34.9, respectively, for screen-and-treat) due to significantly lower personnel costs. Thermal ablation was cost-effective compared to cryotherapy and loop diathermy.
Our study suggests that thermal ablation is a cost-effective option for the screen-and-treat approach to cervical cancer screening compared with cryotherapy and loop diathermy.
Publisher
World Health Organization
Subject
/ Adult
/ Cancer
/ Cervix
/ Costs
/ Early Detection of Cancer - economics
/ Early Detection of Cancer - methods
/ Female
/ Humans
/ Tests
/ Uterine Cervical Neoplasms - diagnosis
/ Uterine Cervical Neoplasms - economics
/ Uterine Cervical Neoplasms - surgery
/ Uterine Cervical Neoplasms - therapy
/ Women
/ Zambia
