alexa Cost-Effectiveness of Primary and Secondary Prevention Strategies for Cervical Cancer in Brazil: A Systematic Review | OMICS International | Abstract
ISSN: 2161-0932

Gynecology & Obstetrics
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Review Article

Cost-Effectiveness of Primary and Secondary Prevention Strategies for Cervical Cancer in Brazil: A Systematic Review

Allex Jardim da Fonseca1,2*, Cibelli Navarro Roldan Martin2, Rebeca Liebich Gusmão Gigante2, Luiz Carlos de Lima Ferreira3 and Giacomo Balbinotto Neto4,5

1Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Amazonas, Universidade Federal de Roraima, Brazil

2Researcher of Post Graduate Program of Health Science of Universidade Federal de Roraima, Brazil

3Professor of Tropical Medicine Post-Graduate Program, Amazonas States University, Tropical Medicine Foundation Dr. Heitor Vieira Dourado, Brazil

4Professor of post Graduate Program in Economics, Federal University of Rio Grande do Sul, Brazil

5Professor of Post-Graduate Program in Economics, Federal University of Rio Grande do Sul, Institute for Health Technology Assessment (IATS), Brazil

*Corresponding Author:
Allex Jardim da Fonseca
Avenida Pedro Teixeira
25. Bairro Dom Pedro
Manaus, Amazonas, Brazil
Tel: + 55 95 81126172
Fax: + 5595 36249253
E-mail: [email protected]

Received Date: August 14, 2013; Accepted Date: September 13, 2013; Published Date: September 18, 2013

Citation: da Fonseca AJ, Roldan Martin CN, Gusmão Gigante RL, de Lima Ferreira LC, Neto GB (2013) Cost-Effectiveness of Primary and Secondary Prevention Strategies for Cervical Cancer in Brazil: A Systematic Review. Gynecol Obstet 3:169. doi: 10.4172/2161-0932.1000169

Copyright: © 2013 da Fonseca AJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Background: Although Cervical Cancer (CC) can be effectively prevented, it is still a serious public health problem, especially in developing countries. In Brazil, almost 18,000 new cases are expected in 2013, and it is the type of neoplasia that claims the most lives of young women. New secondary prevention strategies (such as the HPV-DNA test) and primary prevention strategies (vaccination against HPV) have been developed. However, applying these strategies to large populations is costly, and their use is limited in Brazil. Because financial resources are scarce in Brazilian scenario, studies about the economic implications of the new preventative technologies for CC may support rational and evidence-based decisions in public health.

Methods: A systematic search of the articles (1970 to 2013) was conducted in MEDLINE, EMBASE, Cochrane Collaboration of Systematic Reviews, and LILACS. The aim was original articles that evaluated the cost-effectiveness of primary and/or secondary prevention strategies for cervical cancer in Brazil.

Results: A total of 6 articles were included in this review. Two articles described economic analyses of population screening strategies in comparison to the current strategy in Brazil (oncotic cytology). Four articles evaluated the addition of a vaccine against the HPV (genotypes 16 and 18) for Brazil in comparison to population screening.

Conclusion: Despite raising the costs of preventing cervical cancer, new preventive technologies reveal a favorable cost-effectiveness profile for the case of Brazil. Ignoring the new preventative technologies for CC can lead to misguided and perverse consequences in a country where programs based on the Papanicolaou technique have only been partially successful.


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