Adam Keane (Australia)
Cancer Council New South Wales Cancer Research DivisionPresenter of 2 Presentations
COST-EFFECTIVENESS OF CERVICAL CANCER ELIMINATION IN CHINA (ID 739)
Abstract
Introduction
The WHO has announced an initiative to eliminate cervical cancer, which involves scaling up vaccination (to 90%), twice-lifetime HPV screening (to 70%) and cancer/precancer treatment (to 90%) by 2030. China has the largest burden of cervical cancer in the world, with an estimated 98,900 diagnosed and 30,500 dying from the disease in 2015. Furthermore, cervical cancer rates have recently been increasing. Despite a recently introduced screening program for rural residents, both screening and vaccination coverage remains low, with no national program. We aimed to assess the long-term cost-effectiveness of achieving the 2030 scale-up coverage targets for vaccination and screening in China.
Methods
We use an extensively validated platform (‘Policy1-Cervix’) to evaluate the coordinated scaleup of twice lifetime HPV-based screening and broad-spectrum vaccination. The model was calibrated to local data; screening costs were derived from an original study that applied scaling methods to micro-costing data. A strategy was considered cost-effective if its cost-effectiveness ratio was less than the willingness-to-pay threshold (1xGDP = $US 9770.80 per capita).
Results
Twice-lifetime screening with vaccination was a very cost-effective method of achieving elimination, with a cost-effectiveness ratio of $714/QALYS. This method can potentially achieve elimination (<4/100,000 cancer incidence) by 2064, with a resulting mortality rate of 1.7 by this year. Rapid scale-up of screening and vaccination will result in 1.72 million cases averted and 736,000 lives saved over the 50 year period 2020-2069.
Conclusions
Screening twice per lifetime with high-coverage female vaccination in China would be very cost-effective and could result in elimination of cervical cancer by 2064.