OBJECTIVES: Although cervical cancer is the most prevalent cancer for women in Taiwan, its cost implications to the health system in Taiwan have yet to be thoroughly explored. From the perspective of the health payer, this study aims to investigate the healthcare costs associated with cervical cancer, precancerous lesions and genital warts (GW) treatment in Taiwan.

METHODS: Three patient groups were identified as follows. First, a total of 15,511 new cases of low-grade cervical intraepithelial neoplasia (CIN1) and 3,294 cases of high-grade CIN (CIN2/3) in 2012 were identified from the linked biopsy dataset and pap smear test dataset. Second, a total of 3,418 new cases of GW in 2012 were obtained from the National Health Insurance (NHI) claims database. Third, a total of 4,685 new cases of invasive cervical cancer (ICC) in 2008-2011 were identified from Taiwan cancer registry dataset. Inpatient and outpatient claims associated with treatment of the three patient groups covering 1 year after CIN1, CIN2/3 and GW diagnosis, and 5 years after ICC diagnosis, respectively, were retrieved from the NHI claims database. Per-patient-per-year measurement was used in combination with the bootstrapping method to take into account the issues of skewedness and censoredness at death when estimating the healthcare costs.

RESULTS: The average total costs were NT$2,961.81 for CIN1 and NT$11,244.56 for CIN2/3. The average total costs for the first through the fifth year after ICC diagnosis were NT$375,226.84, NT$81,088.77, NT$53,021.78, NT$38,878.88, and NT$28,160.51, respectively. The average total costs for GW patients were NT$8,677.02.

CONCLUSIONS: Healthcare costs associated with treatment of cervical cancer and precancerous lesions resulted in considerable costs to the healthcare system in Taiwan.