Cost Effectiveness of a Program to Promote Screening forCervical Cancer in the Vietnamese-American Population

Objectives: To conduct a randomized controlled trial to evaluate the cost effectiveness of a lay health workeradministeredcervical cancer screening intervention for Vietnamese-American women.
Methods: The study groupincluded 234 Vietnamese women in the Seattle, Washington area who had not received a Pap test in the last threeyears. Experimental group participants received a lay health worker home visit. The travel distance and timespent at each visit were recorded. Our trial end-point was Pap smear receipt within six months of randomization.Pap testing completion was ascertained through medical record reviews.
Results: For all Vietnamese women,regardless of their prior history of screening, the cost per intervention was $104.0 (95% CI: $89.6-$118.4). Thechange in quality-adjusted life days per intervention was 1.26 (95% CI: -5.43-7.96), resulting in an incrementalcost-effectiveness ratio (ICER) of $30,015 per quality-adjusted life year. The probability that the ICER exceeds$100,000 is 9.1%.
Conclusions: The degree of cost effectiveness of such interventions is sensitive to the assumedduration of behavioral change and the participants’ prior history of screening.