Expenditure and resource utilisation for cervical screening in Australia

Area of Science:

• Public Health
• Epidemiology
• Health Economics

Background:

• The National Cervical Screening Program (NCSP) in Australia uses conventional cytology every 2 years for women aged 18-69.
• The introduction of HPV vaccination in 2007 necessitates a review of current screening recommendations and program resource utilization.
• This study provides a crucial baseline for evaluating future changes to the cervical screening program.

Purpose of the Study:

• To quantify the resource utilization and costs associated with the Australian cervical screening program in 2010.
• To establish a benchmark for assessing the impact of upcoming program modifications, including HPV vaccination and new technologies.

Main Methods:

• A detailed model of Australian cervical screening practices was developed.
• Data from the Victorian Cervical Cytology Registry informed age-specific compliance rates for screening and follow-up.
• Model-derived estimates were applied to the 2010 Australian female population to calculate costs and procedure volumes.

Main Results:

• The total estimated cost of the screening program in 2010 was A$194.8 million.
• Primary screening smears accounted for approximately half of the total cost, with an estimated 1.7 million smears conducted.
• Significant costs were also associated with follow-up of low-grade abnormalities, colposcopies, treatments for precancerous lesions, and invasive cervical cancer management.

Conclusions:

• Primary screening tests represent a substantial portion of the cervical screening program's cost.
• The integration of HPV vaccination, new technologies, and potential changes to screening intervals and age ranges are expected to significantly alter future program expenditures.
• The study's findings offer a vital benchmark for evaluating the cost-effectiveness of proposed changes to Australia's cervical screening strategy.