Treatment methods for cervical intraepithelial neoplasia in England: A cost-effectiveness analysis.
LLETZ
ablation
conisation
cost‐effectiveness
excision
preterm birth
recurrence
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
24 Apr 2024
24 Apr 2024
Historique:
revised:
12
03
2024
received:
17
11
2023
accepted:
02
04
2024
medline:
25
4
2024
pubmed:
25
4
2024
entrez:
25
4
2024
Statut:
aheadofprint
Résumé
To compare the cost-effectiveness of different treatments for cervical intraepithelial neoplasia (CIN). A cost-effectiveness analysis based on data available in the literature and expert opinion. England. Women treated for CIN. We developed a decision-analytic model to simulate the clinical course of 1000 women who received local treatment for CIN and were followed up for 10 years after treatment. In the model we considered surgical complications as well as oncological and reproductive outcomes over the 10-year period. The costs calculated were those incurred by the National Health Service (NHS) of England. Cost per one CIN2+ recurrence averted (oncological outcome); cost per one preterm birth averted (reproductive outcome); overall cost per one adverse oncological or reproductive outcome averted. For young women of reproductive age, large loop excision of the transformation zone (LLETZ) was the most cost-effective treatment overall at all willingness-to-pay thresholds. For postmenopausal women, LLETZ remained the most cost-effective treatment up to a threshold of £31,500, but laser conisation became the most cost-effective treatment above that threshold. LLETZ is the most cost-effective treatment for both younger and older women. However, for older women, more radical excision with laser conisation could also be considered if the NHS is willing to spend more than £31,500 to avert one CIN2+ recurrence.
Identifiants
pubmed: 38659133
doi: 10.1111/1471-0528.17829
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Subventions
Organisme : Swiss National Science Foundation
Pays : Switzerland
Informations de copyright
© 2024 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.
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