Techniques for Determining the Treatment Costs of Cervical Cancer: A Systematic Review

Abstract

Background: Uterine cervical cancer (UCC) represents a public health problem in many part of the world. The use of new technologies is leading to increased treatment costs, resulting in a substantial economic impact worldwide. Standardization of economic evaluation methods is needed to improve comparisons between jurisdictions. Objective: To identify the methods used to measure the cost of treating invasive UCC, and to search for correlations between cancer treatment expenditures and local economies. Methods: We searched articles in MEDLINE, LILACS, and SciELO with no language restrictions, and included publications from January 01, 2007 to December 31, 2016. Studies were included if they described the annual direct cost of invasive cervical cancer and detailed the costing method. Complete economic evaluations were excluded. Results were described in 2016 international dollars. Results: Of 1581 studies initially reviewed, 13 articles were included in the analysis. Six articles used a bottom-up; six used a top-down approach and one used both. Annual cost per patient varied from I$ 2146.22 (Poland) to 34,351.54 (Sweden). Middle-income countries (MIC) spent median 72.52% of its GDP per capita on the treatment of invasive cervical cancer, while high-income countries (HIC) spent median 30.12% (p = 0.032). No significant difference was found when separated by costing method. Conclusions: We found that, for the treatment costs of invasive UCC, the percentages of GDP per capita were statistically higher in MIC than in HIC. However, no significant difference was found between costing methods, and the top-down approach could be used.