Preliminary Comprehensive Evaluation and Analysis of 5 Cervical Cancer Screening Programs in Wuchang District,Wuhan

LI Ying; LU Yuan; LI Dan; LIU Tingting; YI Nianhua

doi:10.13730/j.issn.2097-2148.2025.04.015

Abstract：Objective To compare the performance indicators and health economic costs of 5 cervical cancer screen-ing programs and analyze the cost-effectiveness by preliminary comprehensive evaluation through the early detection cost index(EDCI),so as to explore the appropriate cervical cancer screening programs.Methods A total of 13 798 women aged 30 to 65,with registered and permanent residence in Wuchang district,Wuhan city in 2021 were selected.Artificial intelligence-based cervical thin-prep cytologic test(TCT),human papillomavirus(HPV)test and automatic DNA quanti-tative analysis of cervical exfoliated cells were performed,5 screening programs,namely TCT,HPV,DNA,HPV+TCT and HPV+DNA were formed through single screening methods and combinations of two screening methods.The detec-tion rates of cervical intraepithelial neoplasia,the detection rates of cervical cancer and intraepithelial neoplasia and the early diagnosis rate of cervical cancer screening under different screening programs were analyzed,the total screening cost,the average annual screening cost per person and the average cost of detecting early cases were counted,and the cost-effectiveness of different programs was evaluated through the EDCI.Results Among the 5 screening programs,the detection rate of cervical intraepithelial neoplasia,the detection rate of cervical cancer and intraepithelial neoplasia and the early diagnosis rate of cervical cancer screening of the HPV+TCT program were superior to those of the other 4 programs.The total screening costs,the average annual screening cost per person and the aver-age costs of detecting early cases of the TCT program and the DNA program were almost the same and lower than those of the other 3 screening programs.The preliminary comprehensive evaluation was performed by EDCI,the EDCI of the 5 screening programs from low to high were TCT program,DNA program,HPV program,HPV+TCT program and HPV+DNA program.Conclusion Through the preliminary comprehensive evaluation,the HPV+TCT program per-forms outstandingly in terms of the performance indicators.Its detection rate of cervical intraepithelial neoplasia,the de-tection rate of cervical cancer and intraepithelial neoplasia and the early diagnosis rate of screening are superior to the other 4 programs.Considering the comprehensive health economic input,the average annual screening cost per person and ED-CI of TCT program and DNA program are more cost-effective to the other 3 programs.