Pnm-17: Cost Effectiveness of Human Papillomavirus Testing in Cervical Cancer Diagnosis

Background: Epidemiological studies are shown robust association between human papillomavirus (HPV) and cervical cancer. From 1990 HPV was known as a necessary but insufficient cause of cervical invasive cancer. The purpose of this study was to evaluate the cost effectiveness of HPV test in cervical cancer screening. Materials and Methods: This is a systematic review article; the newest scientific references were used for data gathering. Results: Henry Kitchener in Manchester University compared screening results of 24000 women who were randomly assigned to either on Pap smear and HPV testing group or only Pap smear group and shown that there is no significant difference for diagnosing cervical high grade lesion between groups. In another prospective study compared cost effectiveness of four strategies that were conducted on 100000 women (Pap smear and HPV testing; only Pap smear; colposcopy and HPV testing and only HPV testing). They concluded that HPV testing is cost effectiveness for screening cervical cancer. Mettenorf et al. (2008) in a review study indicated that sensitivity of HPV testing for cervical intraepithelial neoplasia (CIN) 2, 3 was 94.6% while, sensitivity of Pap testing was 55.4%. Specificity of HPV testing (1.94%) was lower than Pap testing (96.8%). Although HPV testing detected more cases of high grade CIN compared to Pap, but this may increase false positive. Maximum sensitivity was achieved by using both HPV and Pap testing for each woman but false positive and utilization of colposcoy were increased. Researcher concluded that HPV testing was cost effective for cervical cancer screening. Flores et al. (2011) showed that using HPV testing or the combination of it and Pap testing is always more cost effective than using Pap test alone. Conclusion: Strategies incorporating HPV testing are not only more effective than screening based on cytology alone but are also highly cost-effective. These results may help policy makers implement HPV testing as part of the cervical cancer screening program.