OBJECTIVE: To evaluate oral cancer screening by visual inspection. METHODS: A cluster randomized controlled trial was initiated in Trivandrum district, Kerala, India. Of 13 population clusters, seven were randomly allocated to three rounds of screening between 1996 and 2004, while standard care was provided in six (control arm). An activity-based approach was employed to calculate costs associated with various components of the screening trial. Information on the resources used and on clinical events in each trial arm was derived from trial databases. Total costs for each cluster were estimated in 2004 United States dollars (US$). The incremental cost per life-year saved was calculated for all eligible individuals and for high-risk individuals (i.e. tobacco or alcohol users). FINDINGS: The proportion of oral cancers detected at an early stage (i.e. stage I or II) was higher in the intervention arm than the control arm (42% versus 24%, respectively). The incremental cost per life-year saved was US$ 835 for all individuals eligible for screening and US$ 156 for high-risk individuals. Oral cancer screening by visual inspection was performed for under US$ 6 per person. CONCLUSION: The most cost-effective approach to oral cancer screening by visual inspection is to offer it to the high-risk population. Targeted screening of this group will ensure that screening can be offered at a reasonable cost in a limited-resource setting.
RCT Entities:
OBJECTIVE: To evaluate oral cancer screening by visual inspection. METHODS: A cluster randomized controlled trial was initiated in Trivandrum district, Kerala, India. Of 13 population clusters, seven were randomly allocated to three rounds of screening between 1996 and 2004, while standard care was provided in six (control arm). An activity-based approach was employed to calculate costs associated with various components of the screening trial. Information on the resources used and on clinical events in each trial arm was derived from trial databases. Total costs for each cluster were estimated in 2004 United States dollars (US$). The incremental cost per life-year saved was calculated for all eligible individuals and for high-risk individuals (i.e. tobacco or alcohol users). FINDINGS: The proportion of oral cancers detected at an early stage (i.e. stage I or II) was higher in the intervention arm than the control arm (42% versus 24%, respectively). The incremental cost per life-year saved was US$ 835 for all individuals eligible for screening and US$ 156 for high-risk individuals. Oral cancer screening by visual inspection was performed for under US$ 6 per person. CONCLUSION: The most cost-effective approach to oral cancer screening by visual inspection is to offer it to the high-risk population. Targeted screening of this group will ensure that screening can be offered at a reasonable cost in a limited-resource setting.
Authors: P M Speight; S Palmer; D R Moles; M C Downer; D H Smith; M Henriksson; F Augustovski Journal: Health Technol Assess Date: 2006-04 Impact factor: 4.014
Authors: Ragini D Singh; N Haridas; Jayendra B Patel; Franky D Shah; Shilin N Shukla; Pankaj M Shah; Prabhudas S Patel Journal: Indian J Clin Biochem Date: 2010-08-25
Authors: Douglas E Morse; Carmen M Vélez Vega; Walter J Psoter; Himilce Vélez; Carmen J Buxó; Linda S Baek; Augusto Elias; Melba Sánchez Ayendez Journal: BMC Public Health Date: 2011-05-26 Impact factor: 3.295
Authors: Franky D Shah; Rasheedunnisa Begum; Bhairavi N Vajaria; Kinjal R Patel; Jayendra B Patel; Shilin N Shukla; Prabhudas S Patel Journal: Indian J Clin Biochem Date: 2011-08-09
Authors: Yuan-Chin Amy Lee; Mohammed Al-Temimi; Jian Ying; Joshua Muscat; Andrew F Olshan; Jose P Zevallos; Deborah M Winn; Guojun Li; Erich M Sturgis; Hal Morgenstern; Zuo-Feng Zhang; Elaine Smith; Karl Kelsey; Michael McClean; Thomas L Vaughan; Philip Lazarus; Chu Chen; Stephen M Schwartz; Maura Gillison; Stimson Schantz; Guo-Pei Yu; Gypsyamber D'Souza; Neil Gross; Marcus Monroe; Jaewhan Kim; Paolo Boffetta; Mia Hashibe Journal: Am J Epidemiol Date: 2020-04-02 Impact factor: 4.897
Authors: Juliana Schussel; Xian Chong Zhou; Zhe Zhang; Kavita Pattani; Francisco Bermudez; Germain Jean-Charles; Thomas McCaffrey; Tapan Padhya; Joan Phelan; Silvia Spivakovsky; Mariana Brait; Ryan Li; Helen Yoo Bowne; Judith D Goldberg; Linda Rolnitzky; Miriam Robbins; A Ross Kerr; David Sirois; Joseph A Califano Journal: Clin Cancer Res Date: 2013-05-01 Impact factor: 12.531