Context Homosexual and bisexual men infected with human immunodeficiency virus (HIV) are at increased risk for human papillomavirus-related anal neoplasia and anal squamous cell carcinoma (SCC).
Objective To estimate the dinical benefits and cost-effectiveness of screening HIV-positive homosexual and bisexual men for anal squamous intraepithelial lesions (ASIL) and anal SCC.
Design Cost-effectiveness analysis performed from a societal perspective that used reference case recommendations from the Panel on Cost-Effectiveness in Health and Medicine.
A state-transition Markov model was developed to calculate lifetime costs, life expectancy, and quality-adjusted life expectancy for no screening vs several screening strategies for ASIL and anal SCC using anal Papanicolaou (Pap) testing at different intervals.
Values for incidence, progression, and regression of anal neoplasia ; efficacy of screening and treatment ; natural history of HIV ; health-related quality of life ; and costs were obtained from the literature.
Setting and Participants Hypothetical cohort of homosexual and bisexual HIV-positive men living in the United States.
Main Outcome Measures Life expectancy, quality-adjusted life expectancy, quality-adjusted years of life saved, lifetime costs, and incremental cost-effectiveness ratio.
Results Screening for ASIL increased quality-adjusted life expectancy at all stages of HIV disease. (...)
Mots-clés Pascal : Carcinome épidermoïde, Anus, Homme, Mâle, Comportement sexuel, Homosexualité, SIDA, Virose, Infection, Bisexualité, Association, Dépistage, Efficacité, Analyse coût efficacité, Economie santé, Etats Unis, Amérique du Nord, Amérique, Epidémiologie, Tumeur maligne, Appareil digestif pathologie, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Squamous cell carcinoma, Anus, Human, Male, Sexual behavior, Homosexuality, AIDS, Viral disease, Infection, Bisexuality, Association, Medical screening, Efficiency, Cost efficiency analysis, Health economy, United States, North America, America, Epidemiology, Malignant tumor, Digestive diseases, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 99-0289131
Code Inist : 002B13B01. Création : 16/11/1999.