Tinelli, Michela; Athanasiou, Antonios; Veroniki, Areti Angeliki; Efthimiou, Orestis; Kalliala, Ilkka; Bowden, Sarah; Paraskevaidi, Maria; Lyons, Deirdre; Martin-Hirsch, Pierre; Bennett, Phillip; Paraskevaidis, Evangelos; Salanti, Georgia; Kyrgiou, Maria; Naci, Huseyin (2024). Treatment methods for cervical intraepithelial neoplasia in England: A cost-effectiveness analysis. BJOG : an international journal of obstetrics and gynaecology, 131(10), pp. 1411-1419. Wiley 10.1111/1471-0528.17829
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OBJECTIVE
To compare the cost-effectiveness of different treatments for cervical intraepithelial neoplasia (CIN).
DESIGN
A cost-effectiveness analysis based on data available in the literature and expert opinion.
SETTING
England.
POPULATION
Women treated for CIN.
METHODS
We developed a decision-analytic model to simulate the clinical course of 1000 women who received local treatment for CIN and were followed up for 10 years after treatment. In the model we considered surgical complications as well as oncological and reproductive outcomes over the 10-year period. The costs calculated were those incurred by the National Health Service (NHS) of England.
MAIN OUTCOME MEASURES
Cost per one CIN2+ recurrence averted (oncological outcome); cost per one preterm birth averted (reproductive outcome); overall cost per one adverse oncological or reproductive outcome averted.
RESULTS
For young women of reproductive age, large loop excision of the transformation zone (LLETZ) was the most cost-effective treatment overall at all willingness-to-pay thresholds. For postmenopausal women, LLETZ remained the most cost-effective treatment up to a threshold of £31,500, but laser conisation became the most cost-effective treatment above that threshold.
CONCLUSIONS
LLETZ is the most cost-effective treatment for both younger and older women. However, for older women, more radical excision with laser conisation could also be considered if the NHS is willing to spend more than £31,500 to avert one CIN2+ recurrence.
Item Type: |
Journal Article (Original Article) |
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Division/Institute: |
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM) 04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM) |
UniBE Contributor: |
Efthimiou, Orestis, Salanti, Georgia |
Subjects: |
600 Technology > 610 Medicine & health 300 Social sciences, sociology & anthropology > 360 Social problems & social services |
ISSN: |
1471-0528 |
Publisher: |
Wiley |
Funders: |
[4] Swiss National Science Foundation |
Language: |
English |
Submitter: |
Pubmed Import |
Date Deposited: |
30 Apr 2024 10:34 |
Last Modified: |
06 Aug 2024 22:35 |
Publisher DOI: |
10.1111/1471-0528.17829 |
PubMed ID: |
38659133 |
Uncontrolled Keywords: |
LLETZ ablation conisation cost‐effectiveness excision preterm birth recurrence |
BORIS DOI: |
10.48350/196254 |
URI: |
https://boris.unibe.ch/id/eprint/196254 |
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