To the Editor: Dr Denny and colleagues1 reported the safety and efficacy of a resource-appropriate approach for cervical cancer screening designed for less-developed countries. This is important because although cervical cancer incidence has decreased significantly in recent decades in economically developed countries, it has remained a major social and economic burden in low-resource countries.2
The introduction of appropriate screening methods and strategies available for low-income women and low-resource countries has become an important challenge in terms of safety, efficacy, and cost-effectiveness in Hungary, which is considered to have a transitional or developing economy. The National Health Insurance Fund Administration, the health care financing agency in Hungary, conducted a cost-effectiveness analysis of cervical cancer screening (including cytologic testing and colposcopy).3 Although the cost per life-year saved was considered to be acceptable, it remained necessary to analyze the budget impact of such a screening program.
We compared the 2001 national treatment cost of cervical and breast cancer in Hungary with an estimate of national direct costs of potential organized screening programs.4 We found that these programs would add a substantial amount to the current expenditures for these conditions. For breast cancer, the annual treatment cost (US $29.9 million) was far higher than the estimated cost of a screening program (US $5.8 million). However, for cervical cancer, the direct cost alone of a screening program with only a 75% participation rate (US $4.5 million) might be higher than the 2001 cost of treatment (US $3.6 million).
Although Hungary decided to implement an organized national cervical cancer screening program, in a country with a transitional economy or low resources the short-term budgetary constrain approach (“budget silo”)5 may be more important for decision makers than a long-term cost-effectiveness approach.
Financial Disclosures: None reported.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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