Background and objective:
In June 2022, Lombardy Region started a new screening campaign for HCV. Ministerial and WHO guidelines on this subject indicate this screening as cost-effective according to data in the literature. Having ascertained, however, that cost-effectiveness ratios can be debated and that in any case the available resources are limited, we wanted to verify the real cost of the screening programme and compare it with the prevention programmes currently active.

Methods:
The costs of each healthcare service were obtained from the 2022 tariff nomenclature. The number of level I, II and III services according to the screening pathway were obtained from the data contained in the 2015 Regional Report on cancer screening (for breast, colon and cervix), containing invitations, adhesions and recall rates, as well as the number of diagnoses (detection rate). A cost of EUR 0.50 per invitation letter was also estimated for colon, cervix and breast screening. Data on HCV screening were obtained from the dedicated software, from June 2022 to the end of November 2022.

Results:
Breast screening had a total cost of 17,474,067 euro with 1,624 diagnosis. Colon screening had a total cost of 4,868,244 euro with 9,236 diagnosis. Cervix screening had a total cost of 1,488,672 euro with 899 diagnosis. HCV screening had a total cost of 992.400 euro with 104 diagnosis. Therefore, per 100.000 euro invested we can estimate the diagnosis of: - 10,17 breast cancer - 189,72 colon cancer or adenoma - 59,72 cervix dysplasia - 10,48 HCV positivity

Conclusion:
HCV screening proves to be cost-effective compared to other prevention programmes active in Lombardy Region. It would be interesting to compare them with the costs of vaccinations by taking into account the cases prevented, starting with the prevalence rate in the pre-vaccination period