ArticlePloS one2015
Costs and Cost Effectiveness of Three Approaches for Cervical Cancer Screening among HIV-Positive Women in Johannesburg, South Africa.
Article in PloS one, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- A systematic review of economic evaluations of cervical cancer screening methods.Systematic reviews · 2022Pooled it
- Costs and cost-effectiveness of HIV/noncommunicable disease integration in Africa: from theory to practice.AIDS (London, England) · 2018Pooled it
- Trial
- Cost of HPV screening at community health campaigns (CHCs) and health clinics in rural Kenya.BMC health services research · 2018Trial
- Trial
- Advancing the elimination of cervical cancer across Africa.Nature communications · 2026Review
- Micro-costing of genetic and genomic testing in oncology: a systematic review of laboratory resources and costs.Health economics review · 2026Review
- The integrated care costs of HIV and non-communicable diseases in South Africa.Public health action · 2024Article
- Economic Evaluation of Cervical Cancer Screening by HPV DNA, VIA, and Pap smear Methods in Indonesia.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Cost-effectiveness of single-visit cervical cancer screening in KwaZulu-Natal, South Africa: a model-based analysis accounting for the HIV epidemic.Frontiers in oncology · 2024Article
- Mathematical Models for Evaluating Effectiveness and Cost-Effectiveness of Cervical Cancer Control Policies in Populations Including Women Living With Human Immunodeficiency Virus: A Scoping Review.Value in health regional issues · 2022Article
- Article
- Article
- National Policies to Prevent and Manage Cervical Cancer in East African Countries: A Policy Mapping Analysis.Cancers · 2020Article
- HPV-FRAME: A consensus statement and quality framework for modelled evaluations of HPV-related cancer control.Papillomavirus research (Amsterdam, Netherlands) · 2019Article
- Cost-Effectiveness of Cervical Cancer Screening in Women Living With HIV in South Africa: A Mathematical Modeling Study.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Cost of Integrating Noncommunicable Disease Screening Into Home-Based HIV Testing and Counseling in South Africa.Journal of acquired immune deficiency syndromes (1999) · 2018Article
- Increased Cervical Human Immunodeficiency Virus (HIV) RNA Shedding Among HIV-Infected Women Randomized to Loop Electrosurgical Excision Procedure Compared to Cryotherapy for Cervical Intraepithelial Neoplasia 2/3.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2018Article
- Cancer screening in women living with HIV infection.Women's health (London, England) · 2017Article
- Cervical cancer risk and impact of Pap-based screening in HIV-positive women on antiretroviral therapy in Johannesburg, South Africa.International journal of cancer · 2017Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundSouth Africa has high rates of HIV and HPV and high incidence and mortality from cervical cancer. However, cervical cancer is largely preventable when early screening and treatment are available. We estimate the costs and cost-effectiveness of conventional cytology (Pap), visual inspection with acetic acid (VIA) and HPV DNA testing for detecting cases of CIN2+ among HIV-infected women currently taking antiretroviral treatment at a public HIV clinic in Johannesburg, South Africa.
methodsMethod effectiveness was derived from a validation study completed at the clinic. Costs were estimated from the provider perspective using micro-costing between June 2013-April 2014. Capital costs were annualized using a discount rate of 3%. Two different service volume scenarios were considered. Threshold analysis was used to explore the potential for reducing the cost of HPV DNA testing.
resultsVIA was least costly in both scenarios. In the higher volume scenario, the average cost per procedure was US$ 3.67 for VIA, US$ 8.17 for Pap and US$ 54.34 for HPV DNA. Colposcopic biopsies cost on average US$ 67.71 per procedure. VIA was least sensitive but most cost-effective at US$ 17.05 per true CIN2+ case detected. The cost per case detected for Pap testing was US$ 130.63 using a conventional definition for positive results and US$ 187.52 using a more conservative definition. HPV DNA testing was US$ 320.09 per case detected. Colposcopic biopsy costs largely drove the total and per case costs. A 71% reduction in HPV DNA screening costs would make it competitive with the conservative Pap definition.
conclusionsWomen need access to services which meet their needs and address the burden of cervical dysplasia and cancer in this region. Although most cost-effective, VIA may require more frequent screening due to low sensitivity, an important consideration for an HIV-positive population with increased risk for disease progression.
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Registered trials
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