African Region (AFR)

The overall goal of the 2024-2028 guideline is to provide a strategic guidance aimed at reducing breast cancer mortality in Ethiopia in alignment with the GBCI targets. 

The three key aims are to:

1. Provide a framework for health facilities on the provision of high quality and effective breast cancer care services at the national level.
2. Provide guidance to policymakers, managers, departmental heads, and other stakeholders on how to implement a breast cancer control program focused on shifting to early diagnosis of the disease over time.
3. Incrementally improve breast cancer management to increase survival and quality of life of patients with breast cancer.

Objective: To estimate the financial and economic costs and the cost–effectiveness of thermal ablation compared to cryotherapy and loop diathermy within a screen-and-treat approach to cervical cancer screening in Zambia.

Methods: We analysed costs within a randomized controlled trial in which women eligible for ablative treatment after cervical cancer screening were assigned to one of three treatment arms: thermal ablation, cryotherapy or loop diathermy. We used a microcosting approach to calculate programme, personnel, equipment and consumable costs for two groups: women treated without follow-up (screened-and-treated) and women who completed follow-up (follow-up-completed). We also estimated trial costs and projected costs if the screen-and-treat approach were to be integrated into routine cervical cancer services. To assess how cost-effective the treatments were, we used a decision tree model.

Findings: Out of the 3124 women who were screened-and-treated, 2386 (76.4%) completed follow-up. In the trial scenario, costs for thermal ablation were lower than cryotherapy and loop diathermy, both per screened-and-treated woman (39.6 United States dollars (US$) versus US$ 42.3 and US$ 50.6, respectively) and per follow-up-completed woman (US$ 55.1 versus US$ 57.9 and US$ 66.2, respectively). In the routine scenario, costs for thermal ablation were also lower than for other treatments (US$ 12.7 versus US$ 15.6 and US$ 34.9, respectively, for screen-and-treat) due to significantly lower personnel costs. Thermal ablation was cost-effective compared to cryotherapy and loop diathermy.

Conclusion: Our study suggests that thermal ablation is a cost-effective option for the screen-and-treat approach to cervical cancer screening compared with cryotherapy and loop diathermy.

ICCP ECHO 2025 Session 7 presentation Guinea

ICCP ECHO 2025 Session 7 presentation Zimbabwe