Two self-sampling strategies for HPV primary cervical cancer screening compared with clinician-collected sampling: an economic evaluation
You are here
Huntington et al, 2023
Objective: Cost comparisons of three sampling strategies (first-void urine self-sampling (Colli-Pee), vaginal self-sampling (Copan FLOWQ) and routine clinician-collected sampling) for HPV primary screening and their impact on number of women screened, number of women lost to follow-up, cost per colposcopy and total screening costs for a plausible range of uptake scenarios.
Affiliations:
- Aquarius Population Health, London, UK.
- Cytology Department, Clinical Sciences Centre, Manchester University NHS Foundation Trust, Manchester, UK.
- Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
- Department of Obstetrics and Gynaecology, St Mary's Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK.
Summary: Cost-consequence analysis from a health system perspective using a deterministic decision tree model for a selected cohort of 10,000 women, aged 25-65 years, eligible for the NHS Cervical Screening Programme (NHSCSP) in England in 2020 and 2021. Three sampling strategies were implemented: 1) self-collected first-void urine; 2) self-collected vaginal swabs; 3) routine clinician-collected cervical samples. The average cost per complete primary HPV screening for cervical cancer was lowest for first-void urine (£38.57), followed by vaginal self-sampling (£40.37; using COPAN FLOQSwab) and clinician-collected cervical samples (£56.81), respectively. The variables most affecting the average cost per screen were the cost of sample collection for clinician-collected sampling and the cost of laboratory HPV testing for the self-sampling strategies. Overall, self-sampling could provide a less costly alternative to clinician-collected sampling for routine HPV primary screening and potentially expand the reach of cervical screening to under-screened women.