Cost effectiveness of a program to promote screening for cervical cancer in the Vietnamese-American population.

OBJECTIVES: To conduct a randomized controlled trial to evaluate the cost effectiveness of a lay health worker-administered cervical cancer screening intervention for Vietnamese-American women.
METHODS: The study group included 234 Vietnamese women in the Seattle, Washington area who had not received a Pap test in the last three years. Experimental group participants received a lay health worker home visit. The travel distance and time spent at each visit were recorded. Our trial end-point was Pap smear receipt within six months of randomization. Pap testing completion was ascertained through medical record reviews.
RESULTS: For all Vietnamese women, regardless of their prior history of screening, the cost per intervention was $104.0 (95% CI: $89.6-$118.4). The change in quality-adjusted life days per intervention was 1.26 (95% CI: -5.43-7.96), resulting in an incremental cost-effectiveness ratio (ICER) of $30,015 per quality-adjusted life year. The probability that the ICER exceeds $100,000 is 9.1%.
CONCLUSIONS: The degree of cost effectiveness of such interventions is sensitive to the assumed duration of behavioral change and the participants' prior history of screening.

RCT Entities:   Population Interventions Outcomes