PMID- 30614498
OWN - NLM
STAT- MEDLINE
DCOM- 20191024
LR  - 20191024
IS  - 1120-9135 (Print)
IS  - 1120-9135 (Linking)
VI  - 30
IP  - 6
DP  - 2018 Nov-Dec
TI  - Epidemiology and cost of cervical cancer care and prevention in Apulia (Italy), 
      2007/2016.
PG  - 490-501
AB  - BACKGROUND: According to recent estimates, cervical cancer is worldwide the 
      second most common cancer in females and the fourth overall. The number of deaths 
      for cervical cancer is around 7.5% of all female cancer deaths. Cervical cancer 
      is the only tumour with a known necessary cause, the HPV infection and, globally, 
      HPV is the most common sexually transmitted infection. Two major approaches for 
      cervical cancer prevention have been designed: primary prevention by HPV 
      vaccination and secondary prevention by screening. The aim of our study is to 
      design an overview of epidemiology, cost of the therapies and cost of prevention 
      measures (screening and vaccines) 9 years after the introduction of anti-HPV 
      vaccination in the Apulia Regional Immunization Program. STUDY DESIGN: 
      Retrospective observational study. METHODS: To describe the epidemiology of 
      cervical cancer, we analysed data from the Apulia regional archive of hospital 
      discharge forms (SDO). We considered all records referred to cervical cancer 
      using the ICD 9 code 180.xxx both in primary and secondary diagnosis, for the 
      years 2007-2016. Subjects living in Apulia have been considered. Costs of 
      hospitalization were computed considering generated Diagnosis Related Groups 
      (DRG). To describe the Apulian screening program, we analysed data from Regional 
      Screening Data warehouse; the cost of the single test was established according 
      to the Tariff List from the Ministry of Health. Finally, vaccination data were 
      extracted by Regional Immunization Database and official ex-factory price has 
      been used to calculate the costs of immunization program. RESULTS: From 2007 to 
      2016, an important decrease in the incidence rate of cervical cancer in Apulia 
      has been noted, ranging from 43.7 per 100,000 residents in 2007 to 21.0 per 
      100,000 residents in 2016. From an economic point of view, a clear reduction 
      (39%) is observed in hospitalization costs over time. Total costs of prevention 
      programs increased over time and globally exceed euro 54,000,000, with a decreasing 
      trend for vaccine prophylaxis and an increasing trend for screening. CONCLUSIONS: 
      The incidence and costs of cervical cancer in Apulia, although already 
      significantly decreasing, likely will be further reduced since 2027-2032, when we 
      can observe the effects of vaccine prophylaxis on the burden of disease; on this 
      occasion it will be also possible to quantify the actual cost-effectiveness of 
      the vaccine. In our opinion, in the future the Apulia healthcare executives 
      should enhance and improve the active screening test offer, without 
      underestimating the importance of sexual education in young people, especially in 
      those who have not had sexual debut yet.
FAU - Bianchi, F P
AU  - Bianchi FP
AD  - Department of Biomedical Science and Human Oncology, Aldo Moro University of 
      Bari, Bari, Italy.
FAU - Gallone, M S
AU  - Gallone MS
AD  - Department of Biomedical Science and Human Oncology, Aldo Moro University of 
      Bari, Bari, Italy.
FAU - Fortunato, F
AU  - Fortunato F
AD  - Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
FAU - Boccalini, S
AU  - Boccalini S
AD  - Department of Health Science, University of Florence, Florence, Italy.
FAU - Martinelli, D
AU  - Martinelli D
AD  - Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
FAU - Prato, R
AU  - Prato R
AD  - Department of Medical and Surgical Sciences, University of Foggia, Foggia, Italy.
FAU - Tafuri, S
AU  - Tafuri S
AD  - Department of Biomedical Science and Human Oncology, Aldo Moro University of 
      Bari, Bari, Italy.
LA  - eng
PT  - Journal Article
PT  - Observational Study
PL  - Italy
TA  - Ann Ig
JT  - Annali di igiene : medicina preventiva e di comunita
JID - 9002865
RN  - 0 (Papillomavirus Vaccines)
SB  - IM
MH  - Child
MH  - Costs and Cost Analysis
MH  - Diagnosis-Related Groups
MH  - Female
MH  - Hospitalization/economics/statistics & numerical data
MH  - Humans
MH  - Incidence
MH  - Italy/epidemiology
MH  - Male
MH  - Mass Screening/economics/methods
MH  - Middle Aged
MH  - Papillomaviridae/isolation & purification
MH  - Papillomavirus Infections/complications/diagnosis/*prevention & control
MH  - Papillomavirus Vaccines/economics
MH  - Primary Prevention/economics
MH  - Retrospective Studies
MH  - Secondary Prevention/economics
MH  - Uterine Cervical Neoplasms/diagnosis/*epidemiology/*prevention & control/virology
MH  - Vaccination/economics
OTO - NOTNLM
OT  - Costs evaluation
OT  - HPV
OT  - Primary and secondary prevention
EDAT- 2019/01/08 06:00
MHDA- 2019/10/28 06:00
CRDT- 2019/01/08 06:00
PHST- 2019/01/08 06:00 [entrez]
PHST- 2019/01/08 06:00 [pubmed]
PHST- 2019/10/28 06:00 [medline]
AID - 10.7416/ai.2018.2249 [doi]
PST - ppublish
SO  - Ann Ig. 2018 Nov-Dec;30(6):490-501. doi: 10.7416/ai.2018.2249.