Epidemiology and costs of cervical cancer screening and cervical dysplasia in Italy
1 Agency for Public Health, Lazio Region, Via di S. Constanza 53, 00198 Rome, Italy
2 Sanofi Pasteur MSD, 8 rue Jonas Salk, 69007 Lyon, France
3 National Research Council, Institute for Research on the Population and Social Policies, Via Nizza 128, 00198 Rome, Italy
4 Centre for Disease Control, Ministry of Health, Via della Civiltà Romana 7, 00144 Rome, Italy
BMC Public Health 2009, 9:71 doi:10.1186/1471-2458-9-71Published: 25 February 2009
We estimated the number of women undergoing cervical cancer screening annually in Italy, the rates of cervical abnormalities detected, and the costs of screening and management of abnormalities.
The annual number of screened women was estimated from National Health Interview data. Data from the Italian Group for Cervical Cancer Screening were used to estimate the number of positive, negative and unsatisfactory Pap smears. The incidence of CIN (cervical intra-epithelial neoplasia) was estimated from the Emilia Romagna Cancer Registry. Patterns of follow-up and treatment costs were estimated using a typical disease management approach based on national guidelines and data from the Italian Group for Cervical Cancer Screening. Treatment unit costs were obtained from Italian National Health Service and Hospital Information System of the Lazio Region.
An estimated 6.4 million women aged 25–69 years undergo screening annually in Italy (1.2 million and 5.2 million through organized and opportunistic screening programs, respectively). Approximately 2.4% of tests have positive findings. There are approximately 21,000 cases of CIN1 and 7,000–17,000 cases of CIN2/3. Estimated costs to the healthcare service amount to €158.5 million for screening and €22.9 million for the management of cervical abnormalities.
Although some cervical abnormalities might have been underestimated, the total annual cost of cervical cancer prevention in Italy is approximately €181.5 million, of which 87% is attributable to screening.