%0 Journal Article
%T Estimation of the costs of cervical cancer screening, diagnosis and treatment in rural Shanxi Province, China: a micro-costing study
%A Ju-Fang Shi
%A Jun-Feng Chen
%A Karen Canfell
%A Xiang-Xian Feng
%A Jun-Fei Ma
%A Yong-Zhen Zhang
%A Fang-Hui Zhao
%A Rong Li
%A Li Ma
%A Zhi-Fang Li
%A Jie-Bin Lew
%A Yan Ning
%A You-Lin Qiao
%J BMC Health Services Research
%D 2012
%I BioMed Central
%R 10.1186/1472-6963-12-123
%X We assumed that future screening programs will be organized at a county level (population ~250,000), and related treatments will be performed at county or prefecture hospitals; therefore, this study was conducted in a county and a prefecture hospital in Shanxi during 2008¨C9. Direct medical costs were estimated by gathering information on quantities and prices of drugs, supplies, equipment and labour. Direct non-medical costs were estimated via structured patient interviews and expert opinion.Under the base case assumption of a high-volume screening initiative (11,475 women screened annually per county), the aggregated direct medical costs of visual inspection, self-sampled careHPV (Qiagen USA) screening, clinician-sampled careHPV, colposcopy and biopsy were estimated as US$2.64,$7.49,$7.95,$3.90 and $5.76, respectively. Screening costs were robust to screening volume (<5% variation if 2,000 women screened annually), but costs of colposcopy/biopsy tripled at the lower volume. Direct medical costs of Loop Excision, Cold-Knife Conization and Simple and Radical Hysterectomy varied from $61¨C544, depending on the procedure and whether conducted at county or prefecture level. Direct non-medical expenditure varied from $0.68¨C$3.09 for screening/diagnosis and $83¨C$494 for pre-cancer/cancer treatment.Diagnostic costs were comparable to screening costs for high-volume screening but were greatly increased in lower-volume situations, which is a key consideration for the scale-up phase of new programs. The study¡¯s findings will facilitate cost-effectiveness evaluation and budget planning for cervical cancer prevention initiatives in China.
%U http://www.biomedcentral.com/1472-6963/12/123/abstract