Análisis comparativo de los costos de la prevención y tratamiento asociados al cáncer de cuello uterino en Ecuador

Abstract

Background: Cervical cancer is the second leading cause of death due to oncological pathologies in Ecuadorian women. Vaccination and early detection are effective in preventing this disease. The costs of cervical cancer treatment are high. Objective: To compare the cost per person for cervical cancer prevention versus the treatment of cervical lesions. Methodology: An analysis of therapeutic recommendations and associated costs for treatment and prevention was conducted based on the cost schedule for the national health system of Ecuador. Results: The investment in prevention varies according to the scheme used. When using the optimal vaccination and scree-ning with cytology, the investment is $395.62 USD. When using the optimal vaccination and human papillomavirus detection scheme, the cost is $761.42 USD. The cost of follow-up for low-grade lesions is $490.7 USD; for high-grade lesions and in situ cancer with outpatient management, it is $685.43 USD. In the case of in situ cancer/Stage IAI/or non-conizable cervixes, the cost reaches $3465.68 USD. For invasive stages I to 2; IB; IIA, it is $23,762.20 USD, and for stages IIB-III-IV, the minimum cost is $28,560.22 USD. Conclusions: The cost of managing advanced and invasive cervical lesions is 10 to 101 times more expensive than prevention per person. The cost for a person with a basic salary of $460 USD would create inequities in access to treatment and survival. The cost per person that the state must cover for the treatment of advanced cervical cancer is much higher than the investment in preven