+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

National cervical cancer prevention program in the Arab States: Strategies and cost-minimization study of the Tunisian case



National cervical cancer prevention program in the Arab States: Strategies and cost-minimization study of the Tunisian case



Vaccine 36(33): 5091-5096



The Arab states geographic region is marked by a low to moderate cervical cancer screening coverage rates and the absence of national human papillomavirus (HPV) vaccination programs, except for the United Arab Emirates. Knowing that the HPV prevalence among Tunisian woman is estimated to 4.9/100 000 according to the "HPV Center" data, this study aims to estimate the cost of a national cervical cancer prevention program in Tunisia using either the primary prevention method (the two-dose schedule anti-HPV vaccine according to the WHO recommendation for young adolescents) or the secondary prevention method (the Pap smear test according to three time-lapse periodicity). The mean incremental cost of one avoided cervical cancer case was calculated for each prevention scenario. The ascending incremental costs by avoided cervical cancer case are: 1- the national vaccination program through the GAVI support ($ 1803), 2- the cervical cancer screening according to 10-year periodicity ($ 8219), 3- the cervical cancer screening according to 5-year periodicity ($ 14,567), 4- the cervical cancer screening according to 3-year periodicity ($ 20,479), 5- and finally the national vaccination program according to the manufacturer marketed price ($ 36,854). Currently, the anti-HPV national vaccination program combined with cervical cancer screening according to 5-year periodicity present the best cost-effective strategy for cervical cancer prevention in Tunisia. This study gives Tunisian decision makers a basis for structured planning and cost apportionment to ensure effective roll-out of the cervical cancer prevention strategies.

Please choose payment method:






(PDF emailed within 0-6 h: $19.90)

Accession: 065343614

Download citation: RISBibTeXText

PMID: 29983258

DOI: 10.1016/j.vaccine.2018.06.070


Related references

From the Centers for Disease Control and Prevention. Strategies for providing follow-up and treatment services in the National Breast and Cervical Cancer Early Detection Program--United States, 1997. JAMA 279(24): 1941-1942, 1998

Cost analysis of the National Breast and Cervical Cancer Early Detection Program: selected states, 2003 to 2004. Cancer 112(3): 626-635, 2008

Strategies for providing follow-up and treatment services in the National Breast and Cervical Cancer Early Detection Program--United States, 1997. Mmwr. Morbidity and Mortality Weekly Report 47(11): 215-218, 1998

Optimal Management Strategies for Primary HPV Testing for Cervical Screening: Cost-Effectiveness Evaluation for the National Cervical Screening Program in Australia. Plos one 12(1): E0163509, 2017

Cervical cancer screening of underserved women in the United States: results from the National Breast and Cervical Cancer Early Detection Program, 1997-2012. Cancer Causes and Control 26(5): 671-686, 2016

Management strategies and cost effectiveness in the prevention of cervical cancer. Clinicoeconomics and Outcomes Research 1: 17-23, 2009

Cost of Operating Central Cancer Registries and Factors That Affect Cost: Findings From an Economic Evaluation of Centers for Disease Control and Prevention National Program of Cancer Registries. Journal of Public Health Management and Practice 22(5): 452-460, 2016

Identifying and controlling for program-level differences in comparative cost analysis: lessons from the economic evaluation of the National Breast and Cervical Cancer Early Detection Program. Evaluation and Program Planning 31(2): 136-144, 2008

Optimizing cervical cancer prevention strategies in the United States. Gynecologic Oncology 127(3): 437-439, 2012

Cost-effectiveness of Korea's National Cervical Cancer Screening Program. Asian Pacific Journal of Cancer Prevention 14(7): 4329-4334, 2013

The cost-utility of integrated cervical cancer prevention strategies in the Ontario setting - Can we do better?. Vaccine 34(16): 1936-1944, 2016

Race-specific results of Papanicolaou testing and the rate of cervical neoplasia in the National Breast and Cervical Cancer Early Detection Program, 1991-1998 (United States). Cancer Causes and Control 12(1): 61-68, 2001

The National Breast and Cervical Cancer Early Detection Program: toward a system of cancer screening in the United States. Cancer 120(Suppl. 16): 2617-2619, 2014

Monitoring a national cancer prevention program: successful changes in cervical cancer screening in the Netherlands. International Journal of Cancer 120(4): 806-812, 2007

Selecting a mix of prevention strategies against cervical cancer for maximum efficiency with an optimization program. Pharmacoeconomics 30(4): 337-353, 2012