Abstract
2) HPV DNA testing followed by Pap smear triage; and 3) self-sampling for HPV testing followed by Pap smear triage. Self-sampling for HPV testing strategy is annual, and another strategies of screening intervals are annually, every 3 years, and every 5 years. The model parameters are collected from the published references and the health-related governments in Taiwan. Outcome measures included life expectancy, quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (ICERs). Probabilistic sensitivity analyses (PSAs) were conducted to assess parameter uncertainty. RESULTS: When three times GDP per capita is used as the decision threshold, and all seven screening strategies were cost-effective compared with the no-screening strategy. Compared with the primary screening strategy (an annual Pap smear), self-sampling HPV testing followed by Pap smear triage, HPV DNA testing followed by Pap smear triage every 5 years and every 3 years were cost-effective. CONCLUSIONS: Self-sampling for HPV testing followed by Pap smear triage is one of the cost-effective screening strategies in Taiwan.
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