Estimating the impact of increasing cervical cancer screening in the National Breast and Cervical Cancer Early Detection Program among low-income women in the USA

Cancer Causes Control. 2020 Jul;31(7):691-702. doi: 10.1007/s10552-020-01314-z. Epub 2020 May 20.

Abstract

Purpose: The National Breast and Cervical Cancer Early Detection Program (NBCCEDP) provides free cervical cancer screening to low-income women. This study estimated the health benefits gained in terms of life years (LYs) saved and quality-adjusted life years (QALYs) gained if cervical cancer screening by the NBCCEDP increased to reach more eligible women.

Methods: Data from Surveillance, Epidemiology, and End Results, NBCCEDP, and Medical Expenditure Panel Surveys were used. LYs saved and QALYs gained/100,000 women were estimated using modeling methods. They were used to predict additional health benefits gained if screening by the NBCCEDP increased from 6.5% up to 10-25% of the eligible women.

Results: Overall, per 100,000 women screened by the NBCCEDP, 1,731 LYs were saved and 1,608 QALYs were gained. For white women, 1,926 LYs were saved and 1,780 QALYs were gained/100,000 women screened by the NBCCEDP. For black women, 1,506 LYs were saved and 1,300 QALYs were gained/100,000 women screened. If the proportion of eligible women screened by the NBCCEDP increased to 10-25%, the estimated health benefits would range from 6,626-34,896 LYs saved and 6,153-32,407 QALYs gained.

Conclusions: The reported estimates emphasize the value of cervical cancer screening program by extending LE in low-income women. Further, it demonstrates that screening a higher percentage of eligible women in the NBCCEDP may yield more health benefits.

Keywords: Cervical cancer; Low-income; National Breast and Cervical Cancer Early Detection Program (NBCCEDP); Screening.

MeSH terms

  • Adolescent
  • Adult
  • Black or African American / statistics & numerical data
  • Breast Neoplasms / epidemiology
  • Early Detection of Cancer / economics
  • Early Detection of Cancer / methods
  • Early Detection of Cancer / statistics & numerical data*
  • Female
  • Humans
  • Middle Aged
  • Models, Statistical
  • Quality-Adjusted Life Years
  • Registries
  • SEER Program
  • Surveys and Questionnaires
  • United States / epidemiology
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / pathology
  • Young Adult