# Evaluating the Cost-Effectiveness of Cervical Cancer Screening and Treatment in Western Romania

## TL;DR

This study evaluates the cost-effectiveness of cervical cancer treatments in western Romania, finding that advanced stages require the most expensive multimodal therapies.

## Contribution

The study introduces a novel approach using AI models to forecast treatment cost-effectiveness based on survival rates and toxicity data in Romania.

## Key findings

- Treatment costs peak at stages IIA–IIIC, averaging €7800–€8300.
- Multimodal treatments (surgery, chemo, radiotherapy) are most costly, exceeding €8000.
- Costs decline sharply in terminal stages (IVB) and early stages (IA, IB).

## Abstract

Background and Objectives: As a leading European country in terms of cervical cancer incidence and mortality, there has been a pressing need for Romania to upgrade its cervical cancer management. The criteria set by the International Federation of Gynecology and Obstetrics indicate that different treatments should have a similar trend concerning progression-free survival and overall survival at all the various stages of cervical cancer. This study aimed to assess the cost-effectiveness (CE) of the primary treatment plans related to the survival rate for cervical cancer screening in the western part of Romania and provide some recommendations. Materials and Methods: Descriptive statistics and a correlation model were used to examine costs. AI models have been developed to forecast the CE of different treatments using the above-mentioned studies on overall survival rates and treatment-related toxicity rates for five years. The costs of cervical cancer treatment were sourced from the public health department, the oncology clinic in the western region of Romania, and the County Hospital available for each stage. Results: Treatment expenses vary by cancer stage, with a significant increase from stages IA/IB to IIA, stabilizing between IIA and IIIC (about €7800–€8300), followed by a steep decline in IVA and a more pronounced decrease in IVB and in situ. The results highlight certain treatment combinations and their costs, indicating that the highest costs (exceeding €8000) are linked to multimodal treatments, which encompass surgery, chemotherapy, radiotherapy, and brachytherapy. Conclusions: Advanced cancer stages (IIA–IIIC) entail the highest treatment costs due to intricate, multimodal therapy, whereas early stages (IA, IB, in situ) and late terminal stages (IVB) are linked to considerably reduced treatment costs.