OBJECTIVES: Cervical cancer is the third most common cancer in Thai women. The success of cervical cancer screening policy is restrained due to various factors that minimize the screening rate. Self-screening could reduce barriers to screening in Thai women. This study aimed to evaluate the cost-utility and budget impact of cervical cancer screening using a self-collected sample kit for HPV DNA testing in Thailand.

METHODS: A decision tree coupled with Markov model was used to estimate lifetime costs and health benefits of listing self-screening policy in the national list of health benefit coverage for women aged 25-65 years. This analysis was performed from a societal perspective. We compared the costs and outcomes of three options including (1) additional self-screening, (2) clinician screening only, and (3) no screening. All costs were reported in 2022 USD. Sensitivity analyses were conducted to assess robustness of the model. The 10-year budget impacts of the additional policy were calculated.

RESULTS: Both additional self-screening and clinician screening only policies were cost-saving, compared to no screening. When compared between the two screening policies, additional self-screening was a dominant strategy. The incremental cervical cancer prevention benefit of adding self-screening into the heath benefit coverage was observed at any additional rate of screening that was expected to be gained by using self-collected sample kit. The sensitivity analyses give the same favorable results of the screening policies. Average annual budget impact of additional self-screening policy was 20.6 million USD. This budget would potentially grant more than 10 million women to undergo cervical cancer screening.

CONCLUSIONS: Cervical cancer screening policies were cost-saving. The advantage of screenings predominated their incremental costs. Policy-makers should consider this evidence in the policy optimization process.