ArticleApplied health economics and health policy2015
Cost effectiveness of human papillomavirus-16/18 genotyping in cervical cancer screening.
Article in Applied health economics and health policy, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 1 of them a synthesis that pooled it.
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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.
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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.
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Who cites it
22 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Simple but not simpler: a systematic review of Markov models for economic evaluation of cervical cancer screening.Clinics (Sao Paulo, Brazil) · 2018Pooled it
- Cost-effectiveness analysis of primary human papillomavirus testing in cervical cancer screening: Results from the HPV FOCAL Trial.Cancer medicine · 2021Trial
- Feasibility of thermocoagulation in a screen-and-treat approach for the treatment of cervical precancerous lesions in sub-Saharan Africa.BMC women's health · 2017Trial
- PAX1 and ZNF582 Methylation as a Triage Strategy in Cytologic and hrHPV+ Scrapings in Both Chinese and Dutch Cohorts.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2026Article
- Cost-effectiveness analysis of human papillomavirus (HPV) genotyping strategies for management of HPV-positive women in cervical cancer screening.International journal of cancer · 2026Article
- Cervical cancer screening by cotesting method for Vietnamese women 25-55 years old: a cost-effectiveness analysis.BMJ open · 2025Article
- Primary human papillomavirus testing vs cotesting: clinical outcomes in populations with different disease prevalence.Journal of the National Cancer Institute · 2024Article
- Histologıcal results of HPV genotyping from a colposcopy center.Archives of gynecology and obstetrics · 2023Article
- Article
- A cross-sectional study exploring triage of human papillomavirus (HPV)-positive women by visual assessment, manual and computer-interpreted cytology, and HPV-16/18-45 genotyping in Cameroon.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2021Article
- Effect of introducing human papillomavirus genotyping into real-world screening on cervical cancer screening in China: a retrospective population-based cohort study.Therapeutic advances in medical oncology · 2021Article
- Cervical screening: ESGO-EFC position paper of the European Society of Gynaecologic Oncology (ESGO) and the European Federation of Colposcopy (EFC).British journal of cancer · 2020Review
- Methylation estimates the risk of precancer in HPV-infected women with discrepant results between cytology and HPV16/18 genotyping.Clinical epigenetics · 2019Article
- Estimated Quality of Life and Economic Outcomes Associated With 12 Cervical Cancer Screening Strategies: A Cost-effectiveness Analysis.JAMA internal medicine · 2019Article
- PCR-reverse dot blot human papillomavirus genotyping as a primary screening test for cervical cancer in a hospital-based cohort.Journal of gynecologic oncology · 2019Article
- Economic evaluation of HPV DNA test as primary screening method for cervical cancer: A health policy discussion in Greece.PloS one · 2019Article
- The Next Generation of Cervical Cancer Screening: Should Guidelines Focus on Best Practices for the Future or Current Screening Capacity?Journal of lower genital tract disease · 2018Article
- Cost-effectiveness analysis study of HPV testing as a primary cervical cancer screening in Thailand.Gynecologic oncology reports · 2017Article
- A Model Approach for Assessing the Benefits of HPV Testing against Cytology in Screening for Cervical Cancer Precursors in ThailandAsian Pacific journal of cancer prevention : APJCP · 2017Article
- A cross-sectional study on HPV testing with type 16/18 genotyping for cervical cancer screening in 11,064 Chinese women.Cancer medicine · 2017Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere is limited understanding of the health economic implications of cervical screening with human papillomavirus (HPV)-16/18 genotyping.
objectiveThe aim of this study was to evaluate the cost effectiveness of cervical cancer primary screening with a HPV-16/18 genotyping test which simultaneously detects 12 other high-risk HPV types.
methodsA Markov cohort model compared four strategies: (1) cytology with reflex HPV testing for atypical squamous cells of undetermined significance (ASC-US); (2) co-testing with cytology and HPV testing; (3) HPV with reflex to cytology; and (4) HPV with 16/18 genotyping and reflex cytology (ASC-US threshold). Screening began at age 30 and was performed triennially over 40 years. Screening sensitivity and specificity values for cervical intraepithelial neoplasia (CIN) 3 were obtained from the Addressing THE Need for Advanced HPV Diagnostics (ATHENA) trial. Outcomes for a 1-year follow-up scenario wherein persistent disease was detected were estimated. Screening and cancer treatment costs were calculated from a US payer's perspective in 2013. Costs and quality-adjusted life-years (QALYs) were discounted at 3 % annually.
resultsApplying a US$50,000/QALY threshold, strategy (4) dominated strategies (2) and (3) by reducing costs and cancer incidence and improving QALYs, and was cost effective versus strategy (1). Accounting for persistent ≥CIN 3 at 1 year, strategy (4) was cost effective versus all other strategies. Detecting HPV-16/18 resulted in earlier diagnosis of clinically relevant ≥CIN 3 at initial screening and efficient use of follow-up resources. Outcomes were most influenced by strategy performance.
conclusionsIncorporating HPV-16/18 genotyping is cost effective and may improve detection of CIN, thereby preventing cervical cancer.
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