Evidence map›Paper›PMID 18314477›Full record

ArticleJournal of the National Cancer Institute2008

Cost-effectiveness of cervical cancer screening with human papillomavirus DNA testing and HPV-16,18 vaccination.

Jeremy D Goldhaber-Fiebert, Natasha K Stout, Joshua A Salomon, Karen M Kuntz, Sue J Goldie

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of the National Cancer Institute, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 80 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
80citing papers in PubMed, 6 pooled it
20.7field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

80 citing papers in PubMed, 6 syntheses or guidelines pooled it, 286 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Trial
  8. Trial
  9. Trial
  10. A study of Amplicor human papillomavirus DNA detection in the atypical squamous cells of undetermined significance-low-grade squamous intraepithelial lesion triage study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2009
    Trial
  11. Article
  12. Human papillomavirus infection and screening strategies.World journal of clinical oncology · 2025
    Review
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
  19. Article
  20. Article

20 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Jeremy D Goldhaber-FiebertDoctoral Program in Health Policy, Decision Science Concentration, Harvard University, Cambridge, MA, USA.
Natasha K Stout
Joshua A Salomon
Karen M Kuntz
Sue J Goldie
Harvard Global Health Institute · USHarvard University · USUniversity of Minnesota · US

Funding

Clinical & Cost Effectiveness of HPV Vaccination in the USR01CA093435 · NCI · HARVARD UNIVERSITY (SCH OF PUBLIC HLTH) · PI GOLDIE, SUE J · 2002 to 2009
$2.4M
NCI NIH HHS R01 CA093435PHS HHS R01 HSO15570-01A1
6 · The paper itself

Abstract

backgroundThe availability of human papillomavirus (HPV) DNA testing and vaccination against HPV types 16 and 18 (HPV-16,18) motivates questions about the cost-effectiveness of cervical cancer prevention in the United States for unvaccinated older women and for girls eligible for vaccination.

methodsAn empirically calibrated model was used to assess the quality-adjusted life years (QALYs), lifetime costs, and incremental cost-effectiveness ratios (2004 US dollars per QALY) of screening, vaccination of preadolescent girls, and vaccination combined with screening. Screening varied by initiation age (18, 21, or 25 years), interval (every 1, 2, 3, or 5 years), and test (HPV DNA testing of cervical specimens or cytologic evaluation of cervical cells with a Pap test). Testing strategies included: 1) cytology followed by HPV DNA testing for equivocal cytologic results (cytology with HPV test triage); 2) HPV DNA testing followed by cytology for positive HPV DNA results (HPV test with cytology triage); and 3) combined HPV DNA testing and cytology. Strategies were permitted to switch once at age 25, 30, or 35 years.

resultsFor unvaccinated women, triennial cytology with HPV test triage, beginning by age 21 years and switching to HPV testing with cytology triage at age 30 years, cost $78,000 per QALY compared with the next best strategy. For girls vaccinated before age 12 years, this same strategy, beginning at age 25 years and switching at age 35 years, cost $41,000 per QALY with screening every 5 years and $188,000 per QALY screening triennially, each compared with the next best strategy. These strategies were more effective and cost-effective than screening women of all ages with cytology alone or cytology with HPV triage annually or biennially.

conclusionsFor both vaccinated and unvaccinated women, age-based screening by use of HPV DNA testing as a triage test for equivocal results in younger women and as a primary screening test in older women is expected to be more cost-effective than current screening recommendations.

Indexed as

AdolescentAdultAgedAged, 80 and overAge FactorsAlphapapillomavirusBiopsyChildColposcopyComputer SimulationCost-Benefit AnalysisDNA, ViralFemaleHuman papillomavirus 16Human papillomavirus 18HumansDNA, ViralPapillomavirus Vaccines

Identifiers

PMID18314477
PMCPMC3099548
OpenAlexW2149186272

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.