Cost-effectiveness of conventional cytology and HPV DNA testing for cervical cancer screening in Colombia

Salud Publica Mex. 2008 Jul-Aug;50(4):276-85. doi: 10.1590/s0036-36342008000400005.


Objective: To assess cost-effectiveness of conventional cytology and HPV DNA testing for cervical-cancer screening in Colombia.

Material and methods: The National Cancer Institute of Colombia (NCIC) in 2007 developed a Markov model on the natural history of cervical cancer; no screening, conventional cytology, and HPV DNA testing were compared. Only direct costs were used. Outcomes comprise cervical cancer mortality, years of life saved, and lifetime costs. Discounted incremental cost-effectiveness ratios were estimated and sensitivity analyses were conducted for key parameters.

Results: Depending on the screening strategy a 69-81% mortality reduction might be expected. The HPV DNA testing every five years is a cost-effective strategy (Incremental Cost-Effectiveness Ratio (ICER): USD$44/YLS) if the cost per test is under USD$31. The effectiveness was sensitive to coverage and primarily to follow-up.

Conclusions: HPV DNA testing is a cost-effective alternative for screening in Colombia. Not only high coverage but high follow-up rates are critical for successful screening programs.

MeSH terms

  • Adult
  • Aged
  • Colombia
  • Cost-Benefit Analysis
  • DNA Probes, HPV / economics*
  • Female
  • Follow-Up Studies
  • Humans
  • Middle Aged
  • Uterine Cervical Neoplasms / pathology*
  • Uterine Cervical Neoplasms / virology*


  • DNA Probes, HPV