{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T11:07:52Z","timestamp":1778843272875,"version":"3.51.4"},"reference-count":37,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T00:00:00Z","timestamp":1766534400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Population Health Management"],"published-print":{"date-parts":[[2026,6,1]]},"abstract":"<jats:p>Cancer is one of the leading causes of morbidity and mortality worldwide, disproportionately affecting low- and middle-income countries (LMICs) due to barriers to obtaining access to health care services and screening programs. The current study aimed to synthesize evidence on cost-effective strategies for cancer screening and early diagnosis in adults (\u226518 years) in LMICs. The literature search was conducted in PubMed, the Cochrane Library, Embase, EconLit, CINAHL, LILACS, Global Health, and the Web of Science Core Collection databases. The review included cost-effectiveness studies compared with standard practices in LMICs. Two reviewers independently assessed eligibility, extracted data, and evaluated methodological quality using the Drummond and Jefferson guidelines. Twelve studies conducted in nine countries across four global regions were included. The results identified that the most cost-effective strategies for cervical cancer were human papillomavirus DNA testing, visual inspection with acetic acid, and combined tests. For breast and prostate cancer, digital breast tomosynthesis and the Prostate Health Index were promising options, repectively. However, limitations were noted in the studies, such as the lack of analysis on productivity changes and the justification of variables in sensitivity analyses. Population-based cancer screening strategies exist but must be adapted to the implementation context to maximize their cost-effectiveness in LMICs.<\/jats:p>","DOI":"10.1177\/19427891251407691","type":"journal-article","created":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T17:03:06Z","timestamp":1767114186000},"page":"151-163","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost-Effectiveness of Screening and Early Diagnosis Strategies for Cancer in the General Adult Population in Low- and Middle-Income Countries: A Systematic Review"],"prefix":"10.1177","volume":"29","author":[{"given":"Akram","family":"Hern\u00e1ndez-V\u00e1squez","sequence":"first","affiliation":[{"name":"Subdirecci\u00f3n de Investigaci\u00f3n de Servicios de Salud (SDISS), Centro de Evaluaci\u00f3n de Tecnolog\u00edas en Salud (CETS), Instituto Nacional de Salud (INS), Lima, Peru."},{"name":"Centro de Excelencia en Investigaciones Econ\u00f3micas y Sociales en Salud, Vicerrectorado de Investigaci\u00f3n, Universidad San Ignacio de Loyola, Lima, Peru."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luc\u00eda","family":"Villar Bernaola","sequence":"additional","affiliation":[{"name":"Subdirecci\u00f3n de Investigaci\u00f3n de Servicios de Salud (SDISS), Centro de Evaluaci\u00f3n de Tecnolog\u00edas en Salud (CETS), Instituto Nacional de Salud (INS), Lima, Peru."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodrigo","family":"Vargas-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Epidemiology and Health Economics Research (EHER), Universidad Cient\u00edfica del Sur, Lima, Peru."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ra\u00fal","family":"Timan\u00e1 Ruiz","sequence":"additional","affiliation":[{"name":"Subdirecci\u00f3n de Investigaci\u00f3n de Servicios de Salud (SDISS), Centro de Evaluaci\u00f3n de Tecnolog\u00edas en Salud (CETS), Instituto Nacional de Salud (INS), Lima, Peru."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,12,24]]},"reference":[{"key":"e_1_3_3_2_2","unstructured":"International Agency for Research on Cancer (IARC). Global cancer observatory. 2024. Available from: https:\/\/gco.iarc.fr\/ [Accessed December 30 2024]."},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00492-7"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40985-018-0080-0"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(22)00241-8"},{"key":"e_1_3_3_6_2","volume-title":"Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem","author":"World Health Organization","year":"2020","unstructured":"World Health Organization. Global Strategy to Accelerate the Elimination of Cervical Cancer as a Public Health Problem. World Health Organization; 2020."},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(18)30003-2"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40985-018-0093-8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-021-08809-1"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30695"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2016.09.726"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.03.001"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1002\/9781119536604"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.l6890"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.3163\/1536-5050.104.3.014"},{"key":"e_1_3_3_16_2","unstructured":"The World Bank. The world by income and region. 2024. Available from: https:\/\/datatopics.worldbank.org\/world-development-indicators\/the-world-by-income-and-region.html [Accessed December 15 2024]."},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-016-0384-4"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.313.7052.275"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-010-0377-z"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.21149\/spm.v56i5.7374"},{"key":"e_1_3_3_21_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.29594"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.Epi-16-0787"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2016-015048"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1007\/s41669-023-00470-7"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10552-010-9694-3"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vhri.2021.07.004"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.31403\/rpgo.v58i41"},{"key":"e_1_3_3_28_2","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.21220"},{"key":"e_1_3_3_29_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41391-020-0243-1"},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2008.08.030"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.vhri.2020.01.005"},{"key":"e_1_3_3_32_2","unstructured":"United Nations. Goal 3 ensure healthy lives and promote well-being for all at all ages. 2024. Available from: https:\/\/sdgs.un.org\/goals\/goal3#targets_and_indicators [Accessed December 30 2024]."},{"key":"e_1_3_3_33_2","doi-asserted-by":"publisher","DOI":"10.1002\/cnr2.1756"},{"key":"e_1_3_3_34_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejso.2024.108742"},{"key":"e_1_3_3_35_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-022-02017-z"},{"key":"e_1_3_3_36_2","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.19.01525"},{"key":"e_1_3_3_37_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12885-017-3974-1"},{"key":"e_1_3_3_38_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jval.2021.07.002"}],"container-title":["Population Health Management"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/19427891251407691","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19427891251407691","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/19427891251407691","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T10:17:01Z","timestamp":1778840221000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/19427891251407691"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,24]]},"references-count":37,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,6,1]]}},"alternative-id":["10.1177\/19427891251407691"],"URL":"https:\/\/doi.org\/10.1177\/19427891251407691","relation":{},"ISSN":["1942-7891","1942-7905"],"issn-type":[{"value":"1942-7891","type":"print"},{"value":"1942-7905","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,24]]}}}