ArticlePloS one2016
Cost-Effectiveness of Different Cervical Screening Strategies in Islamic Republic of Iran: A Middle-Income Country with a Low Incidence Rate of Cervical Cancer.
Article in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 3 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
15 citing papers in PubMed, 3 syntheses or guidelines pooled it, 23 citations in OpenAlex.
- Secondary Prevention of Cervical Cancer: ASCO Resource-Stratified Guideline Update.JCO global oncology · 2022Guideline
- Does health economics research align with the disease burden in the Middle East and North Africa region? A systematic review of economic evaluation studies on public health interventions.Global health research and policy · 2022Pooled it
- Cervical cancer screening in low- and middle-income countries: A systematic review of economic evaluation studies.Clinics (Sao Paulo, Brazil) · 2022Pooled it
- Cost-effectiveness analysis of different types of human papillomavirus vaccination to prevent cervical cancer in Iran.BMC public health · 2025Article
- Review
- Cervical Cancer Prevention, Its Challenges and Solutions in Iran and Worldwide: A Systematic Review.Iranian journal of public health · 2023Review
- Women's Preference for Cervical Cancer Screening Methods in Iran: A Contingent Valuation Survey.Medical journal of the Islamic Republic of Iran · 2022Article
- Disability-Adjusted Life Years (DALY) for Cancers in Iran, 1990 to 2016: Review of Findings from the Global Burden of Disease Study.Iranian journal of public health · 2021Article
- QALY league table of Iran: a practical method for better resource allocation.Cost effectiveness and resource allocation : C/E · 2021Review
- Significance of serum antibodies against HPV E7, Hsp27, Hsp20 and Hp91 in Iranian HPV-exposed women.BMC infectious diseases · 2019Article
- The Relationship between Health Locus of Control and Iranian Women's Beliefs toward Pap Smear Screening.International journal of community based nursing and midwifery · 2019Article
- Article
- Assessment of Preventive Behavior for Cervical Cancer with the Health Belief ModelAsian Pacific journal of cancer prevention : APJCP · 2018Article
- Cost-effectiveness analysis study of HPV testing as a primary cervical cancer screening in Thailand.Gynecologic oncology reports · 2017Article
- Article
Corrections and comments
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Authors and funding
8 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveInvasive cervical cancer (ICC) is the fourth most common cancer among women worldwide. Cervical screening programs have reduced the incidence and mortality rates of ICC. We studied the cost-effectiveness of different cervical screening strategies in the Islamic Republic of Iran, a Muslim country with a low incidence rate of ICC.
methodsWe constructed an 11-state Markov model, in which the parameters included regression and progression probabilities, test characteristics, costs, and utilities; these were extracted from primary data and the literature. Our strategies included Pap smear screening and human papillomavirus (HPV) DNA testing plus Pap smear triaging with different starting ages and screening intervals. Model outcomes included lifetime costs, life years gained, quality-adjusted life years (QALY), and incremental cost-effectiveness ratios (ICERs). One-way sensitivity analysis was performed to examine the stability of the results.
resultsWe found that the prevented mortalities for the 11 strategies compared with no screening varied from 26% to 64%. The most cost-effective strategy was HPV screening, starting at age 35 years and repeated every 10 years. The ICER of this strategy was $8,875 per QALY compared with no screening. We found that screening at 5-year intervals was also cost-effective based on GDP per capita in Iran.
conclusionWe recommend organized cervical screening with HPV DNA testing for women in Iran, beginning at age 35 and repeated every 10 or 5 years. The results of this study could be generalized to other countries with low incidence rates of cervical cancer.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.