[Cost effectiveness of cervical cancer screening strategies in Tunisia]

Cervical cancer is a public health problem in developing countries and is the first cancer among women in several of these countries. Screening using the Pap test is the principle control strategy for this cancer. The aim of this study is to identify the highest cost-effectiveness strategy of Pap test screening, according to age group (20-64 years, 35-64 years and 40-64 years) and the frequency of this test (every 3 years or every 5 years). Number of cases avoid by screening and mean cost to prevent one case were used to compare these screening strategies. The principles results showed that the number of cervical cancer cases avoid increase with the coverage level of the screening and age group size, and decrease with the frequency of the Pap tests. The screening strategy interesting age group "40-64 years" every 5 years observed the highest cost-effectiveness ratio (19 MD); however cost is 23 MD for age grovy 35-64 years. These results lead to choice a frequency of Pap tests every 5 years. However, for determination of age group, other factors, as psycho-social ones, should be taken into account besides economic criterias.