Costs and Benefits of Different Strategies to Screen for Cervical Cancer in Less-Developed Countries

Background: About 80 % of cervical cancers occur in less-developed countries. This disproportionate burden of cervi-cal cancer in such countries is due mainly to the lack of well-organized screening programs. Several cervical cancer screening strategies have been proposed as more cost-effective than cytology screening. We compared the costs and benefits of different strategies and their effectiveness in saving lives in a less-developed country. Methods: We used a population-based simulation model to evaluate the incre-mental societal costs and benefits in Thailand of seven screening techniques, including visual inspection of the cer-vix after applying acetic acid (VIA), human papillomavirus (HPV) testing, Pap smear, and combinations of screening tests, and examined the discounted costs per year of life saved (LYS). Results: Compared with no (i.e., not well