ArticleEuropean journal of cancer (Oxford, England : 1990)2018
Adapting cervical cancer screening for women vaccinated against human papillomavirus infections: The value of stratifying guidelines.
Article in European journal of cancer (Oxford, England : 1990), 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 1 of them a synthesis that pooled it.
What it found
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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.
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.
Who cites it
29 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Canadian Guideline on the Management of a Positive Human Papillomavirus Test and Guidance for Specific Populations.Current oncology (Toronto, Ont.) · 2023Guideline
- Cost-effectiveness of risk-stratified screening for cervical cancer in cohorts vaccinated against human papillomavirus with moderate vaccination coverage.International journal of cancer · 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
- Optimal cervical cancer screening strategies for unvaccinated and HPV-vaccinated cohorts in the United States: a comprehensive comparative modeling analysis.Lancet regional health. Americas · 2026Article
- A Scoping Review on the Economic Impacts of Healthy Ageing Promotion and Disease Prevention in OECD Member Countries.International journal of environmental research and public health · 2025Article
- Optimizing the Harms and Benefits of Cervical Screening in a Partially Vaccinated Population in Ontario, Canada: A Modeling Study.Medical decision making : an international journal of the Society for Medical Decision Making · 2025Article
- Cervical cancer screening by cotesting method for Vietnamese women 25-55 years old: a cost-effectiveness analysis.BMJ open · 2025Article
- Vaccination and screening strategies to accelerate cervical cancer elimination in Norway: a model-based analysis.British journal of cancer · 2024Article
- Cervical HPV Infections, Sexually Transmitted Bacterial Pathogens and Cytology Findings-A Molecular Epidemiology Study.Pathogens (Basel, Switzerland) · 2023Article
- Article
- The Future of Cervical Cancer Prevention: From "One-Size-Fits-All" to Personalized Screening.Journal of personalized medicine · 2023Article
- Matrix factorization for the reconstruction of cervical cancer screening histories and prediction of future screening results.BMC bioinformatics · 2022Article
- Review
- Performance of Cervical Screening a Decade Following HPV Vaccination: The Costa Rica Vaccine Trial.Journal of the National Cancer Institute · 2022Article
- Risk Stratification in Cost-Effectiveness Analyses of Cancer Screening: Intervention Eligibility, Strategy Choice, and Optimality.Medical decision making : an international journal of the Society for Medical Decision Making · 2022Article
- Are We Facing a New Colposcopic Practice in the HPV Vaccination Era? Opportunities, Challenges, and New Perspectives.Vaccines · 2021Article
- Screening for cervical cancer: Choices & dilemmas.The Indian journal of medical research · 2021Review
- The Differential Risk of Cervical Cancer in HPV-Vaccinated and -Unvaccinated Women: A Mathematical Modeling Study.Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology · 2021Article
- Time Trends Analysis of Cervical Cancer Incidence in Cluj County, Romania, Using Data from a Population-Based Cancer Registry.Current oncology (Toronto, Ont.) · 2021Article
- Human papillomavirus genotype-specific risks for cervical intraepithelial lesions.Human vaccines & immunotherapeutics · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundSeveral countries have implemented vaccination against human papillomavirus (HPV) for adolescent girls and must decide whether and how to adapt cervical cancer (CC) screening for these low-risk women. We aimed to identify the optimal screening strategies for women vaccinated against HPV infections and quantify the amount that could be spent to identify vaccination status among women and stratify CC screening guidelines accordingly.
methodsWe used a mathematical model reflecting HPV-induced CC in Norway to project the long-term health benefits, resources and costs associated with 74 candidate-screening strategies that varied by screening test, start age and frequency. Strategies were considered separately for women vaccinated with the bivalent/quadrivalent (2/4vHPV) and nonavalent (9vHPV) vaccines. We used a cost-effectiveness framework (i.e. incremental cost-effectiveness ratios and net monetary benefit) and a commonly-cited Norwegian willingness-to-pay threshold of €75,000 per quality-adjusted life-year gained.
resultsThe most cost-effective screening strategy for 9vHPV- and 2/4vHPV-vaccinated women involved HPV testing once and twice per lifetime, respectively. The value of stratifying guidelines by vaccination status was €599 (2/4vHPV) and €725 (9vHPV) per vaccinated woman. Consequently, for the first birth cohort of ∼22,000 women who were vaccinated in adolescence in Norway, between €10.5-13.2 million over their lifetime could be spent on identifying individual vaccination status and stratify screening while remaining cost-effective.
conclusionLess intensive strategies are required for CC screening to remain cost-effective in HPV-vaccinated women. Moreover, screening can remain cost-effective even if large investments are made to identify individual vaccination status and stratify screening guidelines accordingly.
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Registered trials
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.