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Open Access Highly Accessed Research article

Estimation of savings of life-years and cost from early detection of cervical cancer: a follow-up study using nationwide databases for the period 2002–2009

Mei-Chuan Hung1, Meng-Ting Liu1, Ya-Min Cheng2* and Jung-Der Wang13*

Author Affiliations

1 Department of Public Health, National Cheng Kung University College of Medicine, No.1, University Road, Tainan, Taiwan

2 Department of Obstetrics and Gynecology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, 138 Sheng-Li Road, Tainan, Taiwan

3 Departments of Internal Medicine and Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan

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BMC Cancer 2014, 14:505  doi:10.1186/1471-2407-14-505

Published: 10 July 2014

Abstract

Background

Few studies consider both the survival and financial benefits of detection of invasive cervical cancer (ICC) at earlier stages. This study estimated the savings in life-years and costs from early diagnosis of cervical cancer using an ex post approach.

Methods

A total of 28,797 patients diagnosed with cervical cancer in the period 2002–2009 were identified from the National Cancer Registry of Taiwan, and linked to the National Mortality Registry until the end of 2011. Life expectancies (LE) for cancer at different stages were estimated using a semi-parametric extrapolation method. The expected years of life lost (EYLL) for cancer were calculated by subtracting the LE of the cancer cohort from that of the age-and sex-matched general population. The mean lifetime costs after diagnosis paid by the single-payer National Health Insurance during (NHI) 2002–2010 were estimated by multiplying average monthly expenditures by the survival probabilities and summing up over lifetime.

Results

ICC at stages 1 to 4 had an average EYLL of 6.33 years, 11.64 years, 12.65 years, and 18.61 years, respectively, while the related lifetime costs paid by the NHI were $7,020, $10,133, $11,120, and $10,015 US dollars, respectively; the younger the diagnosis age, the higher the savings with regard to EYLL. The mean lifetime costs of managing cervical cancer were generally lower for the earlier stages compared with stages 3 and 4.

Conclusions

Early detection of ICC saves lives and reduces healthcare costs. These health benefits and monetary savings can be used for cost-effectiveness assessments and the promotion of regular proactive screening, especially among older women.

Keywords:
Life-years; Cost; Early detection; Cervical cancer; Semi-parametric extrapolation