Using Simulation Optimization to Construct Efficient Screening Strategies for Cervical Cancer

Cervical cancer is the second most common type of cancer in women worldwide. Because cervical cancer is usually asymptomatic until the disease is in its advanced stages, cervical screening is of central importance towards combating cervical cancer. Alternative screening strategies are evaluated fr...

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Bibliographic Details
Main Author: Foufoulides, Christodoulos
Format: Others
Published: VCU Scholars Compass 2008
Subjects:
Online Access:http://scholarscompass.vcu.edu/etd/1605
http://scholarscompass.vcu.edu/cgi/viewcontent.cgi?article=2604&context=etd
Description
Summary:Cervical cancer is the second most common type of cancer in women worldwide. Because cervical cancer is usually asymptomatic until the disease is in its advanced stages, cervical screening is of central importance towards combating cervical cancer. Alternative screening strategies are evaluated from an economic point of view through cost-effectiveness analysis. In the literature however, studies perform cost-effectiveness analysis on a limited number of de facto or predetermined screening policies. At present, no attempt has been made to construct efficient screening strategies through optimization, before cost-effectiveness analysis is applied. In this study simulation optimization is used to construct efficient screening strategies for cervical cancer by properly timing the screenings. The constructed strategies are highly cost-effective when a small number of lifetime screenings is available, and are more cost-effective than screening strategies used in practice or considered in the literature so far, indicating the value of optimal timing for other screened diseases as well.