Comparator Strategies in Cost-Effectiveness Analyses of HPV Testing in Cervical Screening

CERVIVA investigators have recently published a review of economic analyses of new HPV-based tests in cervical cancer screening. Screening for cervical cancer with HPV tests is generally found to be more effective than conventional screening that uses cytology tests (smear tests) alone. HPV testing can also be cost-effective as long as, like all screening interventions, it is used within appropriate age groups and is not conducted too frequently. The review showed that many economic analyses of HPV testing have not considered a sufficient number of alternative screening strategies. In particular, many analyses do not include sufficient alternative screening strategies with relatively long intervals between screens of 5 years or more. Including sufficient alternative strategies is an important aspect of a good economic analysis. The paper also highlights how it is likely that some published assessments of HPV testing produce over-optimistic cost-effectiveness estimates.

This research is relevant for screening services in Ireland as it highlights the need for appropriately specified cost-effectiveness analyses of HPV testing in population screening. Any changes to CervicalCheck, the already successful national cervical screening programme, will be informed in part by health economic evidence. It is important that the right evidence is generated to ensure the best possible screening services.

The review is published in Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research.