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  1. The costs, clinical benefits, and cost-effectiveness of screening for cervical cancer in HIV-infected Women.

    Article - En anglais

    Background 

    Women with HIV infection have a higher risk for cervical squamous intraepithelial lesions than do women without HIV infection, and the optimal regimen for cervical cancer screening in these women is uncertain.

    Objective 

    To assess the net health consequences, costs, and cost-effectiveness of various screening strategies for cervical neoplasia and cancer in HIV-infected women.

    Design 

    A cost-effectiveness analysis from a societal perspective done by using a state-transition Markov model.

    Values for incidence, progression, and regression of cervical neoplasia ; efficacy of screening and treatment ; progression of HIV disease ; mortality from HIV infection and cancer ; quality of life ; and costs were obtained from the literature.

    Setting 

    Simulated clinical practice in the United States.

    Patients 

    HIV-infected women representative of the U.S. population.

    Intervention 

    Six main screening strategies-no screening, annual Papanicolaou smears, annual Papanicolaou smears after two negative smears obtained 6 months apart (recommended by the Centers for Disease Control and Prevention), semiannual Papanicolaou smears, annual colposcopy, and semiannual colposcopy-were considered.

    Measurements 

    Quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness.

    Results 

    Annual Papanicolaou smear screening resulted in a 2.1-month gain in quality-adjusted life expectancy for an incremental cost of $12 800 per QALY saved. (...)

    Mots-clés Pascal : Carcinome épidermoïde, Cou, SIDA, Virose, Infection, Asymptomatique, Dépistage, Coût, Analyse avantage coût, Economie, Homme, Tumeur maligne, ORL pathologie, Immunopathologie, Immunodéficit

    Mots-clés Pascal anglais : Squamous cell carcinoma, Neck, AIDS, Viral disease, Infection, Asymptomatic, Medical screening, Costs, Cost benefit analysis, Economy, Human, Malignant tumor, ENT disease, Immunopathology, Immune deficiency

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 99-0118317

    Code Inist : 002B30A04B. Création : 16/11/1999.