Ginecologia e Obstetrícia

Ginecologia e Obstetrícia
Acesso livre

ISSN: 2161-0932


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

Allex Jardim da Fonseca, Cibelli Navarro Roldan Martin, Rebeca Liebich Gusmao Gigante, Luiz Carlos de Lima Ferreira and Giacomo Balbinotto Neto

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.