Costs of cervical cancer screening and treatment using visual inspection with acetic acid (VIA) and cryotherapy in Ghana: The importance of scale

Tropical Medicine and International Health

Volumn 16, Issue 3, 2011, Pages 379-389

  Quentin, Wilm ^a   Adu Sarkodie, Yaw ^b   Terris Prestholt, Fern ^c   Legood, Rosa ^c   Opoku, Baafuor K ^b   Mayaud, Philippe ^c  

^a TECHNISCHE UNIVERSITÄT BERLIN   (Germany)

^b KWAME NKRUMAH UNIVERSITY OF SCIENCE AND TECHNOLOGY   (Ghana)

^c LONDON SCHOOL OF HYGIENE AND TROPICAL MEDICINE   (United Kingdom)

Author keywords

Africa; Costs and cost analysis; Early detection of cancer; Economics; Uterine cervical neoplasms

Indexed keywords

CANCER; COST-BENEFIT ANALYSIS; ESTIMATION METHOD; PUBLIC HEALTH; SENSITIVITY ANALYSIS; WOMENS HEALTH;

ARTICLE; CANCER PREVENTION; CANCER SCREENING; COST UTILITY ANALYSIS; CRYOTHERAPY; EARLY DIAGNOSIS; FEMALE; GHANA; HEALTH CARE MANPOWER; HEALTH CARE POLICY; HEALTH CARE UTILIZATION; HEALTH PROGRAM; HUMAN; NATIONAL HEALTH SERVICE; RESOURCE MANAGEMENT; SCALE UP; UTERINE CERVIX CANCER; VISUAL INSPECTION WITH ACETIC ACID;

ACETIC ACID; CRYOTHERAPY; EARLY DETECTION OF CANCER; EARLY DIAGNOSIS; FEMALE; GHANA; HEALTH CARE COSTS; HUMANS; INDICATORS AND REAGENTS; MODELS, ECONOMETRIC; UTERINE CERVICAL NEOPLASMS;

GHANA;

EID: 79951745874     PISSN: 13602276     EISSN: 13653156     Source Type: Journal    
DOI: 10.1111/j.1365-3156.2010.02722.x     Document Type: Article

References (44)

1. Blumenthal PD, Gaffikin L, Deganus S et al. (2007) Cervical cancer prevention: safety, acceptability, and feasibility of a single-visit approach in Accra, Ghana. American Journal of Obstetrics and Gynecology 196, 407.e1-8; discussion 407.e8-9.
2. Bonanni P, Boccalini S & Bechini A (2009) Efficacy, duration of immunity and cross protection after HPV vaccination: a review of the evidence. Vaccine 27(Suppl 1), A46-A53.
3. Briggs A, Sculpher M & Buxton M (1994) Uncertainty in the economic evaluation of health care technologies: the role of sensitivity analysis. Health Economics 3, 95-104.
4. Cagle AJ, Hu SY, Sellors JW et al. (2010) Use of an expanded gold standard to estimate the accuracy of colposcopy and visual inspection with acetic acid. International Journal of Cancer 126, 156-161.
5. Chandrashekar S, Guinness L, Kumaranayake L et al. (2010) The effects of scale on the costs of targeted HIV prevention interventions among female and male sex workers, men who have sex with men and transgenders in India. Sexually Transmitted Infections 86(Suppl 1), i89-i94.
6. Creese A & Parker D (1994) Cost Analysis in Primary Health Care: A Training Manual for Programme Managers. World Health Organization (WHO), Geneva.
7. Cuzick J, Arbyn M, Sankaranarayanan R et al. (2008) Overview of human papillomavirus-based and other novel options for cervical cancer screening in developed and developing countries. Vaccine 26(Suppl 10), K29-K41.
8. Dandona L, Kumar SG, Ramesh YK et al. (2008) Outputs, cost and efficiency of public sector centres for prevention of mother to child transmission of HIV in Andhra Pradesh, India. BMC Health Services Research 8, 26.
9. Denny L, Kuhn L, De Souza M et al. (2005) Screen-and-treat approaches for cervical cancer prevention in low-resource settings: a randomized controlled trial. JAMA 294, 2173-2181.
10. Denny L, Quinn M & Sankaranarayanan R (2006) Chapter 8: screening for cervical cancer in developing countries. Vaccine 24(Suppl 3), S3-S71.
11. Drummond MF, Sculpher MJ, Torrance GW, O'Brien BJ & Stoddart GL (2005) Chapter 4: cost analysis. In: Methods for the Economic Evaluation of Health Care Programmes, 3rd edn (eds MF Drummond, MJ Sculpher, GW Torrance, BJ O'Brien & GL Stoddart ) Oxford University Press, New York, pp. 55-102.
12. Elbasha EH & Messonnier ML (2004) Cost-effectiveness analysis and health care resource allocation: decision rules under variable returns to scale. Health Economics 13, 21-35.
13. FIGO (2009) Global Guidance for Cervical Cancer Prevention and Control. International Federation of Gynecology & Obstetrics (FIGO), London.
14. Gakidou E, Nordhagen S & Obermeyer Z (2008) Coverage of cervical cancer screening in 57 countries: low average levels and large inequalities. PLoS Medicine 5, e132.
15. GHS (2000) Costing of Hospital Services: Evidence for Policy and Planning. Ghana Health Service (GHS), Accra.
16. Goldie SJ, Kuhn L, Denny L, Pollack A & Wright TC (2001) Policy analysis of cervical cancer screening strategies in low-resource settings: clinical benefits and cost-effectiveness. JAMA 285, 3107-3115.
17. Goldie SJ, Gaffikin L, Goldhaber-Fiebert JD et al. (2005) Cost-effectiveness of cervical-cancer screening in five developing countries. New England Journal of Medicine 353, 2158-2168.
18. Goldie SJ, O'Shea M, Campos NG et al. (2008) Health and economic outcomes of HPV 16, 18 vaccination in 72 GAVI-eligible countries. Vaccine 26, 4080-4093.
19. IMF (2009a) World Economic Outlook Database. International Monetary Fund (IMF), Washington, DC. Available at:
20. IMF (2009b) World Economic Outlook Database. Selected indicators for Ghana, International Monetary Fund (IMF), Washington, D.C. Available at:
21. JHPIEGO (2008) Outcomes Research Study on Cervical Cancer Prevention and Treatment: Results from Ghana. JHPIEGO, Baltimore.
22. Legood R, Gray AM, Mahe C et al. (2005) Screening for cervical cancer in India: how much will it cost? A trial based analysis of the cost per case detected International Journal of Cancer 117, 981-987.
23. Mandelblatt JS, Lawrence WF, Gaffikin L et al. (2002) Costs and benefits of different strategies to screen for cervical cancer in less-developed countries. Journal of the National Cancer Institute 94, 1469-1483.
24. MOH (2007) Service Availability Mapping (SAM). Draft, Ministry of Health (MOH), WHO country office, DFID, Accra, Ghana.
25. MOH (2009) Independent Review. Health Sector Program of Work 2008 (Draft). Ministry of Health, Accra.
26. Odoi-Agyarko H (2003) Profile of Reproductive Health Situation in Ghana. World Health Organisation, Country Office Ghana, Accra.
27. Parkin DM & Bray F (2006) Chapter 2: the burden of HPV-related cancers. Vaccine 24(Suppl 3), S3-S11.
28. Parkin DM, Bray F, Ferlay J & Pisani P (2005) Global cancer statistics, 2002. CA: A Cancer Journal for Clinicians 55, 74-108.
29. Pretorius RG, Bao Y, Belinson JL, Burchette RJ, Smith JS & Qiao Y (2007) Inappropriate gold standard bias in cervical cancer screening studies. International Journal of Cancer 121, 2218-2224.
30. Qiao YL, Sellors JW, Eder PS et al. (2008) A new HPV-DNA test for cervical-cancer screening in developing regions: a cross-sectional study of clinical accuracy in rural China. Lancet Oncology 9, 929-936.
31. Sanghvi H, Limpaphayom KK, Plotkin M et al. (2008) Cervical cancer screening using visual inspection with acetic acid: operational experiences from Ghana and Thailand. Reproductive Health Matters 16, 67-77.
32. Sangwa-Lugoma G, Mahmud S, Nasr SH et al. (2006) Visual inspection as a cervical cancer screening method in a primary health care setting in Africa. International Journal of Cancer 119, 1389-1395.
33. Sankaranarayanan R & Wesley R (2003) A Practical Manual on Visual Screening for Cervical Neoplasia, IARC Technical Publication No. 41. International Agency for Research on Cancer (IARC) and World Health Organization (WHO), Lyon.
34. Sankaranarayanan R, Basu P, Wesley RS et al. (2004) Accuracy of visual screening for cervical neoplasia: results from an IARC multicentre study in India and Africa. International Journal of Cancer 110, 907-913.
35. Sankaranarayanan R, Gaffikin L, Jacob M, Sellors J & Robles S (2005) A critical assessment of screening methods for cervical neoplasia. International Journal of Gynaecology and Obstetrics 89(Suppl 2), S4-S12.
36. Sankaranarayanan R, Esmy PO, Rajkumar R et al. (2007) Effect of visual screening on cervical cancer incidence and mortality in Tamil Nadu, India: a cluster-randomised trial. Lancet 370, 398-406.
37. Sankaranarayanan R, Nene BM, Shastri SS et al. (2009) HPV screening for cervical cancer in rural India. New England Journal of Medicine 360, 1385-1394.
38. Sherris JS, Wittet A, Kleine J et al. (2009) Evidence-based, alternative cervical cancer screening approaches in low-resource settings. International Perspectives on Sexual and Reproductive Health 35, 147-154.
39. Shibuya K, Mathers CD, Boschi-Pinto C, Lopez AD & Murray CJ (2002) Global and regional estimates of cancer mortality and incidence by site: II. Results for the global burden of disease 2000. BMC Cancer 2, 37.
40. Tan-Torres Edejer T, Baltussen R, Adam T, Hutubessy R, Acharya A, Evans DB et al. (2003) Making choices in health: WHO guide to cost-effectiveness analysis. World Health Organization (WHO), Geneva.
41. Walboomers JM, Jacobs MV, Manos MM et al. (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. Journal of Pathology 189, 12-19.
42. WHO (2002) Cervical Cancer Screening in Developing Countries: Report of a WHO Consultation. World Health Organization (WHO), Geneva.
43. WHO (2006) Country Health System Fact Sheet 2006: Ghana. World Health Organization, Regional Office Africa, Brazzaville.
44. WHO/ICO (2007) Summary Report on HPV and Cervical Cancer Statistics in Ghana, WHO/ICO Information Centre on HPV and Cervical Cancer. HPV Information Centre, Barcelona.