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A Micro-costing Study of Community-Based Primary HPV Self-Sampling and Triage Test for Cervical Cancer Screening in
Ziyue Zhang1, Hermann Bussmann2, Sathiarany Vong3
1Heidelberg Institute of Global Health, Heidelberg University Hospital and Medical Faculty, Im Neuenheimer Feld 130.3, 69120, Heidelberg, Germany.
Pharmacoeconomics - Open
|May 26, 2026
Summary
Community-based human papillomavirus (HPV) self-sampling offers a cost-effective approach to cervical cancer screening in rural Cambodia. Program costs are mainly driven by laboratory testing and community outreach, providing valuable data for scaling up HPV screening programs.
Area of Science:
- Public Health
- Epidemiology
- Health Economics
Background:
- Cervical cancer screening coverage in rural areas is often limited.
- Community-based human papillomavirus (HPV) self-sampling can improve access.
- Limited data exists on the programmatic costs of HPV self-sampling in low-resource settings.
Purpose of the Study:
- To estimate the start-up and implementation costs of a community-based HPV self-sampling and triage program.
- To analyze cost drivers and provide economic evidence for scaling up cervical cancer screening in rural Cambodia.
Main Methods:
- An activity-based micro-costing study was conducted from a healthcare system perspective.
- Data collected via direct observation, staff interviews, and financial reports (January 2022-December 2023).
- Costs were converted to 2024 US dollars.
Main Results:
- Total programmatic cost was US$204,507.14 for screening 7524 women.
- Average cost per woman screened was US$27.18; per HPV-positive case identified was US$569.66.
- Laboratory testing (55.01%) and community self-sampling (31.12%) were the primary cost components.
Conclusions:
- Community-based HPV self-sampling is feasible at a moderate cost in rural Cambodia.
- Program costs are significantly influenced by laboratory expenses and community-based delivery.
- Findings support budgeting and planning for HPV screening program expansion.
