PIN21 - ECONOMIC BURDEN OF CERVICAL SCREENING AND TREATMENT OF HPV-RELATED CERVICAL LESIONS AND CANCERS IN EUROPE

Abstract

Cervical cancer is the sixth leading cancer among European women. Country-specific data on costs of management of HPV-related cervical lesions and cancers are important for decision-makers to determine the value of public health interventions including screening and vaccination. We compiled published information on screening and management costs of HPV-related cervical diseases in Europe. PubMed/EMBASE were systematically searched for cost-of-illness studies, published from February 2013–October 2017, reporting on country-level economic burden of screening, diagnosis, treatment, and follow-up of HPV-related cervical lesions (intraepithelial neoplasia, adenocarcinoma in situ and minor cytological abnormalities) and cancers among the general European population. Key exclusion criteria were limited age range (<25 or >45 years only), not English, and patient or regional level data only. Data extracted included, costing year, sources and types of costs and population information. Out of 2,625 studies screened, five (from Belgium, Finland, Poland and Sweden) met the inclusion criteria; only one estimated indirect costs. Annual direct costs of cervical cancer screening were 22.6€ million in Belgium, 30.7€ million in Finland 45.9zl (11.2€) million in Poland, and 49.8€ million in Sweden. Women aged 25-44 years represented 40% (22.4€ million) of the screening costs in Finland. Annual direct costs of diagnosis and treatment of cervical lesions were 6.8€ million in Finland, 69.0zl (16.8€) million in Poland, and 5.2€ million in Sweden. Annual direct costs of diagnosis and treatment of cervical cancer were 3.6€ million in Finland, 52.4zl (12.8€) million in Poland, and €18.1 million in Sweden. In Sweden, indirect costs (productivity losses) were 18.1€, 0.8€ and 4.8€.million for screening, management of cervical lesions and cancers, respectively. Although majority of costs associated with cervical cancer detection and treatment in developed countries are attributable to cervical cancer screening, follow up of abnormal cytology results to prevent disease progression consumes substantial healthcare resources.