Authors' objectives: To improve the cost-effectiveness of Taiwanˇ¦s public cervical cancer screening program, this study will compare the cost-effectiveness of the current Pap smear screening strategy in Taiwan with internationally recommended HPV testing strategies (with or without Pap smear) at different screening ages and intervals, providing a basis for future screening policy adjustments.

Authors' results and conclusions: According to the local cost-effectiveness analysis, expanding the screening age to 25 years old resulted in an ICER below WTP threshold of three times GDP per capita for all intervention strategies compared to the current screening strategy (annual Pap smear for those aged 30 and over, and without HPV vaccination). Among these, Strategy S1 (annual Pap smear for those aged 25 and over), Strategy S2 (Pap smear every 3 years starting at age 25), and Strategy S3 (Pap smear every 3 years for ages 25-29, and annually for those aged 30 and over) were the most advantageous screening options. The results of the probabilistic sensitivity analysis showed that, at a WTP threshold of three times GDP per capita, the probability of being cost-effective were ranked from highest to lowest as follows: S2, S1, S3, S1-4 (annual screening for individuals aged 25 and older, with co-testing at ages 35, 45, and 65), and S3-4 (screening every 3 years for individuals aged 25-29, annual screening for individuals aged 30 and older, with co-testing at ages 35, 45, and 65).

Authors' recommendations: It is recommended that future screening policies be relaxed incrementally based on the cost-effectiveness probability of various screening strategies, from highest to lowest, to gradually expand the scope of subsidies. Therefore, the screening starting age could be set at 25 years old, with screening intervals of once every 3 years, and co-testing at ages 35, 45, and 65 could be considered in policy planning.

Authors' methods: The research method included searching for and compiling relevant policies and cost-effectiveness literature on cervical cancer screening in various countries. It also utilized recent screening and cancer registry data from Taiwan to establish local epidemiological parameters, and then performed a cost-effectiveness analysis of cervical cancer screening in the local context to compare the cost-effectiveness of different screening strategies.

Project Status: Completed

Year Published: 2024

URL for published report: https://www.cde.org.tw/media/ckihcy1x/%E5%AD%90%E5%AE%AE%E9%A0%B8%E6%8A%B9%E7%89%87%E6%AA%A2%E6%9F%A5%E8%88%87hpv%E6%AA%A2%E6%B8%AC%E4%B9%8B%E6%88%90%E6%9C%AC%E6%95%88%E7%9B%8A%E6%AF%94%E8%BC%83%E5%88%86%E6%9E%90-%E6%91%98%E8%A6%81.pdf?mediaDL=true

English language abstract: An English language summary is available

Publication Type: Not Assigned

Organisation Name: Center for Drug Evaluation

Contact Address: 3F.,No.465, Sec.6, Zhongxiao E. Rd., Taipei 11557, Taiwan. R.O.C.

Contact Name: Li Ying (Grace) Huang

Contact Email: lyhuang277@cde.org.tw