Cost-Effective Cervical Cancer Screening Strategies for Women with HIV in KwaZulu-Natal

By Rene Pretorius

January 20, 2025

Evaluating Cost-Effective Cervical Cancer Screening in High HIV-Prevalence Settings

In this review we summarize the results of a study on the cost-effectiveness of single-visit cervical cancer screening strategy in KwaZulu-Natal, South Africa. The region faces high HIV prevalence, increasing the risk of cervical cancer. A dynamic transmission model was used to compare HPV DNA testing, genotyping, and automated visual evaluation (AVE) against the current multi-visit approach. Findings show that repeat single-visit screening with HPV DNA testing is the most effective and cost-efficient strategy, especially for women living with HIV (WLHIV). This approach aligns with WHO recommendations.

Key Findings on Cervical Cancer Screening

KwaZulu-Natal has a significant burden of HIV and HPV. Women with HIV face a higher risk of developing cervical cancer due to weakened immune systems.

Repeat single-visit cervical cancer screening with HPV DNA testing reduces cervical cancer cases and deaths. This method provides a practical and effective alternative to multi-visit strategies.

The study finds that repeat HPV DNA testing has an incremental cost-effectiveness ratio (ICER) below South Africa’s GDP per capita threshold. This makes it a financially viable option for national programs.

Expanding HPV vaccination coverage to 90% could significantly lower cervical cancer cases and deaths. However, the high cost of the nonavalent HPV vaccine remains a challenge.

Automated visual evaluation (AVE) shows promise for future HPV screening. However, uncertainties about cost and performance require further study before widespread adoption.

Challenges such as inadequate infrastructure, insufficient trained personnel, and loss to follow-up hinder effective cervical cancer screening in resource-limited settings.

Context and Policy Considerations

The WHO aims to eliminate cervical cancer by 2030 with its 90-70-90 targets. These include vaccinating 90% of girls, screening 70% of women with high-performance tests, and ensuring 90% of women with pre-cancerous lesions receive treatment.

Women living with HIV are more susceptible to HPV and its progression to cervical cancer. Their compromised immune status accelerates disease development, highlighting the need for targeted screening strategies.

Many low- and middle-income countries (LMICs) struggle to expand HPV screening. Limited infrastructure, equipment, and trained professionals remain major obstacles.

Studies confirm the cost-effectiveness of single-visit cervical cancer screening and HPV DNA testing. Findings emphasize the need for repeat screening and integrating emerging technologies like AVE.

Implications for Health Policy and Research

Implementing cost-effective screening strategies in LMICs can improve health outcomes at manageable costs. HPV DNA testing in single-visit models aligns with WHO recommendations and enhances healthcare efficiency.

For WLHIV, screening every five years minimizes cervical cancer risk. For HIV-negative women, screening at ages 35–39 and 45–49 offers effective protection.

Policymakers must invest in HPV DNA testing and vaccination programs. Scaling up these efforts in high HIV prevalence areas will significantly reduce cervical cancer incidence and mortality.

Future Research Directions

Further studies should explore AVE’s cost-effectiveness and integration into existing cervical cancer screening programs. Addressing uncertainties in performance and affordability will support better decision-making.

This study highlights critical insights for health economics and outcomes research. Investing in single-visit cervical cancer screening strategies will improve access to care and long-term public health outcomes.

Reference url

Recent Posts

oral health Africa
    

Oral Health in Africa: Promoting Collaborative Solutions

🦷 Is oral health taking a back seat in public health discussions in Africa?

A new article reveals alarming statistics about the high prevalence of untreated dental diseases across the continent and a critical shortage of oral health professionals. It emphasizes the urgent need for collaborative action among healthcare providers and policy-makers to integrate oral health into broader public health frameworks.

Discover how strengthening partnerships can pave the way for improved health outcomes and resource allocation in oral health.

#SyenzaNews #globalhealth #HealthEconomics

tislelizumab NSCLC treatment
        

Early Benefit Assessment of Tislelizumab NSCLC Treatment: Insights and Implications

🧐 How is the evolving treatment landscape for NSCLC affecting patient access to tislelizumab?

The German Federal Joint Committee (G-BA) has launched an early benefit assessment for tislelizumab as a second-line treatment for adults with advanced NSCLC. This assessment notably focuses on PD-L1 negative patients and highlights the need for additional data to substantiate its value amidst a shifting emphasis on first-line immunotherapy.

Explore the nuances of this assessment and its implications for future research and market access in the full article.

#SyenzaNews #oncology #MarketAccess

colorectal cancer screening
    

Advances in Colorectal Cancer Screening: Access and Cost

🚀 Is blood-based screening redefining colorectal cancer detection?

The Shield blood test offers a non-invasive alternative to colonoscopy—boosting screening uptake, but raising questions around effectiveness and value.

🔍 Discover how this innovation could reshape patient care, payer strategy, and health system costs.

#SyenzaNews #HealthcareInnovation #CostEffectiveness #DigitalTransformation

When you partner with Syenza, it’s like a Nuclear Fusion.

Our expertise are combined with yours, and we contribute clinical expertise and advanced degrees in health policy, health economics, systems analysis, public finance, business, and project management. You’ll also feel our high-impact global and local perspectives with cultural intelligence.

SPEAK WITH US

CORRESPONDENCE ADDRESS

1950 W. Corporate Way, Suite 95478
Anaheim, CA 92801, USA

© 2025 Syenza™. All rights reserved.