OBJECTIVE: The purpose of this study was to examine the health care costs of cervical human papillomavirus-related disease in a US health care setting. STUDY DESIGN: We conducted an observational cohort study using 1997 through 2002 administrative and laboratory records from 103,476 female enrollees of the Kaiser Permanente Northwest health plan (Portland, Ore). We examined the cost per case and annual cost per 1000 enrollees for cervical human papillomavirus-related events. RESULTS: A cervical examination with a normal routine papanicolaou smear incurred costs of 57 dollars (95% CI, 57-57). Costs that were associated with abnormal routine screening diagnoses ranged from 299 dollars for atypical squamous cells (95% CI, 245-352) to 2349 dollars for high-grade squamous intraepithelial lesion (95% CI, 1,047-3,650). The costs of histologically confirmed cervical intraepithelial neoplasia ranged from 1026 dollars for cervical intraepithelial neoplasia 1 (95% CI, 862-1191) to 3235 dollars for cervical intraepithelial neoplasia 3 (95% CI, 2051-4419); a cost of 376 dollars (95% CI, 315-436) was associated with false-positive test results. At the level of the health plan, overall annual cervical cancer prevention and treatment costs were 26,415 dollars per 1000 female enrollees, with routine cervical cancer screening accounting for expenditures of 16,746 dollars per 1000 female enrollees, cervical intraepithelial neoplasia accounting for expenditures of 4535 dollars per 1000 female enrollees, cervical cancer accounting for expenditures of 2629 dollars per 1000 female enrollees, and false-positive test results accounting for expenditures of 2394 dollars per 1000 female enrollees. CONCLUSION: These are the first direct estimates of both individual and population level costs of cervical human papillomavirus-related disease in a general US health care setting. Routine cervical cancer screening comprises nearly two thirds of total annual cervical human papillomavirus-related health care costs, with 10% of expenditures dedicated to the treatment of invasive cervical cancer, 17% to the management of cervical precancers, and 9% to dealing with false-positive Papanicolaou test results.
OBJECTIVE: The purpose of this study was to examine the health care costs of cervical human papillomavirus-related disease in a US health care setting. STUDY DESIGN: We conducted an observational cohort study using 1997 through 2002 administrative and laboratory records from 103,476 female enrollees of the Kaiser Permanente Northwest health plan (Portland, Ore). We examined the cost per case and annual cost per 1000 enrollees for cervical human papillomavirus-related events. RESULTS: A cervical examination with a normal routine papanicolaou smear incurred costs of 57 dollars (95% CI, 57-57). Costs that were associated with abnormal routine screening diagnoses ranged from 299 dollars for atypical squamous cells (95% CI, 245-352) to 2349 dollars for high-grade squamous intraepithelial lesion (95% CI, 1,047-3,650). The costs of histologically confirmed cervical intraepithelial neoplasia ranged from 1026 dollars for cervical intraepithelial neoplasia 1 (95% CI, 862-1191) to 3235 dollars for cervical intraepithelial neoplasia 3 (95% CI, 2051-4419); a cost of 376 dollars (95% CI, 315-436) was associated with false-positive test results. At the level of the health plan, overall annual cervical cancer prevention and treatment costs were 26,415 dollars per 1000 female enrollees, with routine cervical cancer screening accounting for expenditures of 16,746 dollars per 1000 female enrollees, cervical intraepithelial neoplasia accounting for expenditures of 4535 dollars per 1000 female enrollees, cervical cancer accounting for expenditures of 2629 dollars per 1000 female enrollees, and false-positive test results accounting for expenditures of 2394 dollars per 1000 female enrollees. CONCLUSION: These are the first direct estimates of both individual and population level costs of cervical human papillomavirus-related disease in a general US health care setting. Routine cervical cancer screening comprises nearly two thirds of total annual cervical human papillomavirus-related health care costs, with 10% of expenditures dedicated to the treatment of invasive cervical cancer, 17% to the management of cervical precancers, and 9% to dealing with false-positive Papanicolaou test results.
Authors: Linda M Niccolai; Pamela J Julian; Alyssa Bilinski; Niti R Mehta; James I Meek; Daniel Zelterman; James L Hadler; Lynn Sosa Journal: Am J Public Health Date: 2012-04-19 Impact factor: 9.308
Authors: Jane R Montealegre; Indu Varier; Christina G Bracamontes; Laura M Dillon; Martial Guillaud; Andrew G Sikora; Michele Follen; Karen Adler-Storthz; Michael E Scheurer Journal: Ethn Health Date: 2017-09-04 Impact factor: 2.772
Authors: Harrell W Chesson; Lauri E Markowitz; Susan Hariri; Donatus U Ekwueme; Mona Saraiya Journal: Hum Vaccin Immunother Date: 2016-02-18 Impact factor: 3.452
Authors: Jean-François Laprise; Harrell W Chesson; Lauri E Markowitz; Mélanie Drolet; Dave Martin; Élodie Bénard; Marc Brisson Journal: Ann Intern Med Date: 2019-12-10 Impact factor: 25.391
Authors: Betty Chou; Lauren S Krill; Bernice B Horton; Christopher E Barat; Cornelia L Trimble Journal: Obstet Gynecol Date: 2011-07 Impact factor: 7.661
Authors: Joakim Dillner; Susanne K Kjaer; Cosette M Wheeler; Kristján Sigurdsson; Ole-Erik Iversen; Mauricio Hernandez-Avila; Gonzalo Perez; Darron R Brown; Laura A Koutsky; Eng Hseon Tay; Patricia García; Kevin A Ault; Suzanne M Garland; Sepp Leodolter; Sven-Eric Olsson; Grace W K Tang; Daron G Ferris; Jorma Paavonen; Matti Lehtinen; Marc Steben; F Xavier Bosch; Elmar A Joura; Slawomir Majewski; Nubia Muñoz; Evan R Myers; Luisa L Villa; Frank J Taddeo; Christine Roberts; Amha Tadesse; Janine T Bryan; Roger Maansson; Shuang Lu; Scott Vuocolo; Teresa M Hesley; Eliav Barr; Richard Haupt Journal: BMJ Date: 2010-07-20