Cost-Utility Analysis of Interventions to Reduce the Burden of Cervical Cancer in Israel

• All screening and/or vaccine ($33 per dose) interventions were very cost effective.
• PAP smears should be provided to persons aged 20–64 on a penta-annual basis.
• HPV vaccinations at age 12 should be introduced.
• HPV DNA testing for persons aged 30–64 every five years is also recommended.

Using World health Organization, CHOosing Interventions that are Cost Effective (WHO-CHOICE) methodology, cost-utility ratios were calculated for various interventions (Papanicolaou [Pap] smear, human papillomavirus [HPV]-DNA testing, visual inspection with acetic acid [VIA] and vaccination against HPV) at various frequencies to reduce the burden of cervical cancer and condyloma (in the case of the HPV vaccination) in Israel, which has a low prevalence of cervical cancer. All of the screening and/or vaccine interventions were very cost-effective. Attempts should be made to raise compliancy with Pap smears from the current opportunistic 12.1% per annum to screen everyone aged 20-64 once every 5 years in combination with HPV-DNA testing for persons aged 30–64 both before and/or after HPV vaccination is introduced.This article forms part of a regional report entitled “Comprehensive Control of HPV Infections and Related Diseases in Israel” Vaccine Volume 31, Supplement 8, 2013. Updates of the progress in the field are presented in a separate monograph entitled “Comprehensive Control of HPV Infections and Related Diseases” Vaccine Volume 30, Supplement 5, 2012.