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.
To assess the net health consequences, costs, and cost-effectiveness of various screening strategies for cervical neoplasia and cancer in HIV-infected women.
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.
Simulated clinical practice in the United States.
HIV-infected women representative of the U.S. population.
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.
Quality-adjusted life-years (QALYs), lifetime costs, and incremental cost-effectiveness.
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
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0118317
Code Inist : 002B30A04B. Création : 16/11/1999.