ArticleBMJ open2025
Cervical cancer screening by cotesting method for Vietnamese women 25-55 years old: a cost-effectiveness analysis.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis 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
2 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Cervical cancer screening policy inequality worldwide: a systematic review of disparities in access and implementation.Journal of translational medicine · 2026Pooled it
- Minimal benefit of co-testing over HPV primary screening with cytology triage from resource-limited settings in China.Communications medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundCervical cancer (CC) is preventable through regular screening and vaccination against human papillomavirus (HPV). However, CC remains a significant public health issue in low-income and middle-income countries (LMICs) like Vietnam, where financial constraints hinder the widespread implementation of HPV vaccination and screening programmes. Currently, Vietnam lacks both a national CC screening intervention and an HPV vaccination programme for women and girls. To date, cost-effectiveness studies evaluating CC screening methods in Vietnam remain limited.
objectivesTo evaluate the cost-effectiveness of two CC screening strategies for Vietnamese women aged 25-55 years: (1) cotesting combining cytology and HPV testing conducted three times at 5 year intervals (intervention) and (2) cytology-based screening conducted five times at 2 year intervals (comparator). The objective is to provide evidence to inform policy and clinical practice in Vietnam.
designCost-effectiveness analysis using a Markov model with 1 year cycles to simulate the natural progression of CC.
settingThe Vietnamese healthcare system, modelled from the provider's perspective, with parameters adapted to the local context through expert consultations.
participantsA simulated cohort of Vietnamese women aged 25-55 years.
interventionsThe intervention involved cotesting (cytology and HPV testing) three times at 5 year intervals. The comparator was cytology-based screening conducted five times at 2 year intervals. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome measure was quality-adjusted life years (QALYs). Costs and cost-effectiveness ratios were assessed using Vietnam's gross domestic product (GDP) per capita as the cost-effectiveness threshold (1-3 times GDP per capita). Sensitivity analyses (one-way deterministic and probabilistic) were conducted to account for uncertainties.
resultsThe cotesting strategy was less effective and more costly than cytology-based screening across all age groups. Cotesting resulted in higher costs and fewer QALYs than the comparator. Probabilistic sensitivity analyses confirmed that cotesting was not cost-effective under current conditions in Vietnam.
conclusionsCytology-based screening conducted five times at 2 year intervals is a more cost-effective option for CC screening in Vietnamese women aged 25-55 years. The cotesting strategy cannot be recommended due to its higher cost and lower effectiveness.
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