Present evidence on the value of HPV testing for cervical cancer screening: a model-based exploration of the (cost-)effectiveness.
Loading...
Authors
Ballegooijen, M. van
Marle, M. E. van den Akker-van
Warmerdam, P. G.
Meijer, C. J.
Walboomers, J. M.
Habbema, J. D.
Issue Date
1997
Type
Article
Language
en_US
Keywords
HPV Testing , Cervical Cancer Screening
Alternative Title
Abstract
Human papillomavirus (HPV) is the main risk factor for invasive cervical cancer. High risk ratios are found in cross-sectional data on HPV prevalence. The question raised is whether this present evidence is sufficient for making firm recommendations on HPV screening. A validated cervical cancer screening model was extended by adding HPV infection as a possible precursor of cervical intraepithelial neoplasia (CIN). Two widely different model quantifications were constructed so that both were compatible with the observed HPV risk ratios. One model assumed a much longer duration of HPV infection before progressing to CIN and a higher sensitivity of the HPV test than the other. In one version of the model, the calculated mortality reduction from HPV screening was higher and the (cost-)effectiveness was much better than for Pap smear screening. In the other version, outcomes were the opposite, although the cost-effectiveness of the combined HPV + cytology test was close to that of Pap smear screening. Although small follow-up studies and studies with limited strength of design suggest that HPV testing may well improve cervical cancer screening, only large longitudinal screening studies on the association between HPV infection and the development of neoplasias can give outcomes that would enable a firm conclusion to be made on the (cost-)effectiveness of HPV screening. Prospective studies should address women aged 30-60 years.
Description
Citation
van Ballegooijen, M., van den Akker-van Marle, M. E., Warmerdam, P. G., Meijer, C. J., Walboomers, J. M., & Habbema, J. D. (1997). Present evidence on the value of HPV testing for cervical cancer screening: a model-based exploration of the (cost-)effectiveness. British journal of cancer, 76(5), 651–657. https://doi.org/10.1038/bjc.1997.440
Publisher
British Journal of Cancer