Table 2 Total resource required for screening and cost per detected and treated CIN2+ lesion (in euros). Estimates in self-sampling as a 2nd reminder for two different follow-up strategies after a hrHPV-positive self-taken sample. In the main estimate, sampler price is at 2.0 euros and cost of hrHPV-analysis at 20.0 euros. For breakdown of costs, see Table 1
Primary invitation only | One reminder | Two reminders | |||
|---|---|---|---|---|---|
Reminder by self-sampling | Reminder by reminder letter | Reminders by reminder letter & self-sampling | Reminders by reminder letter & self-sampling | ||
Follow-upa: Pap-smear triage, compliance 82 % | Follow-upa: Pap-smear triage, compliance 79 % | Follow-upa: direct colposcopy, compliance 90 % | |||
Primary invitation | |||||
Cost per screened woman (prim. testingb) | 31 | 31 | 31 | 31 | 31 |
Total costs | 3,210,443 | 3,210,443 | 3,210,443 | 3,210,443 | 3,210,443 |
Cost per treated CIN2+ | 15,288 | 15,288 | 15,288 | 15,288 | 15,288 |
1st reminder | |||||
Cost per screened woman (prim. testingb) | 43 | 33 | 33 | 33 | |
Total costs | 707,049 | 452,496 | 452,496 | 452,496 | |
Cost per extra treated CIN2+ | 16,443 | 10,284 | 10,284 | 10,284 | |
2nd reminder | |||||
Cost per screened woman (prim. testingb) | 53 | 50 | |||
Total costs | 396,944 | 826,393 | |||
Cost per extra treated CIN2+ | 12,805 | 23,611 | |||
Total costs of screening | |||||
Cost per screened woman (prim. testingb) | 31 | 33 | 31 | 33 | 32 |
Total costs | 3,210,443 | 3,917,492 | 3,662,939 | 4,059,883 | 4,489,332 |
Cost per treated CIN2+ | 15,288 | 15,484 | 14,421 | 14,245 | 15,534 |
Total cost increase by reminders | - | 22 % | 14 % | 26 % | 40 % |
Achieved attendance rate | 70.0 % | 79.4 % | 78.1 % | 82.6 % | 82.6 % |
Increase in CIN2+ detection | 20 % | 21 % | 36 % | 38 % | |
Additional analysis: | |||||
Self-sampling opt-out rate 15 % | |||||
Cost per screened woman (prim. testingb) | 41 | 49 | 47 | ||
Cost per detected CIN2+ (by reminder) | 15,930 | 12,285 | 23,175 | ||
Sampler price = 6.5 euros | |||||
Cost per screened woman (prim. testingb) | 58 | 75 | 72 | ||
Cost per CIN2+ lesion (by reminder) | 19,583 | 15,984 | 26,427 | ||
Cost per CIN2+ lesion (total) | 16,018 | 14,591 | 15,875 | ||
Cost of HPV-analysis = 15–30 euros | |||||
Cost per screened woman (prim. testingb) | 38–54 | 48–63 | 45–60 | ||
Cost per CIN2+ lesion (by reminder) | 15,327–18,676 | 12,063–14,288 | 22,954–24,925 | ||
Cost per CIN2+ lesion (total) | 15,294–15,864 | 14,165–14,407 | 15,454–15,693 | ||
Sampler price = 6.5 euros & cost of HPV-analysis = 30 euros | |||||
Cost per screened woman (prim. testingb) | 68 | 85 | 82 | ||
Cost per CIN2+ lesion (by reminder) | 21,815 | 17,467 | 27,741 | ||
Cost per CIN2+ lesion (total) | 16,397 | 14,752 | 16,034 | ||
Compliance to Pap-smear triage = 70 % | |||||
Cost per CIN2+ lesion (by reminder) | 18,553 | 13,966 | |||
Cost per CIN2+ lesion (total) | 15,766 | 14,377 | |||
Compliance to Pap-smear triage = 70 % & cost of HPV-analysis 30 euros & sampler price = 6.5 euros | |||||
Cost per CIN2+ lesion (by reminder) | 24,970 | 19,320 | |||
Cost per CIN2+ lesion (total) | 16,705 | 14,892 | |||
CIN yield by self-sampling +20 % compared to reminder letter (1.2 x yield by reminder letter) | |||||
Cost per CIN2+ lesion (by reminder) | 14,150 | ||||
Cost per CIN2+ lesion (total) | 15,066 | ||||
CIN yield by self-sampling +50 % compared to reminder letter (1.5 x yield by reminder letter) | |||||
Cost per CIN2+ lesion (by reminder) | 11,644 | ||||
Cost per CIN2+ lesion (total) | 14,421 | ||||
Reminder letter participation rate = 14 % | |||||
Cost per CIN2+ lesion | 10,693 | ||||
Increase in costs by reminders | 7.7 % | ||||
Increase in CIN2+ detection (total) | 11.0 % | ||||