Evidence map›Paper›PMID 32660432›Full record

Trial reportBMC cancer2020

Cost-effectiveness analysis of repeated self-sampling for HPV testing in primary cervical screening: a randomized study.

Riina Aarnio, Ellinor Östensson, Matts Olovsson, Inger Gustavsson, Ulf Gyllensten

Abstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMC cancer, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 3 pooled it
–field-weighted citation impact
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

25 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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  13. To eliminate cervical cancer in Canada, nationwide funding of self-sampling for human papillomavirus is needed.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Riina AarnioDepartment of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden. riina.aarnio@kbh.uu.se.ORCID http://orcid.org/0000-0001-6752-531X
Ellinor ÖstenssonDepartment of Women's and Children's Health, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.
Matts OlovssonDepartment of Women's and Children's Health, Uppsala University, 751 85, Uppsala, Sweden.
Inger GustavssonDepartment of Immunology, Genetics, and Pathology, Biomedical Center, SciLifeLab Uppsala, Uppsala University, Box 815, 75108, Uppsala, Sweden.
Ulf GyllenstenDepartment of Immunology, Genetics, and Pathology, Biomedical Center, SciLifeLab Uppsala, Uppsala University, Box 815, 75108, Uppsala, Sweden.

Funding

Cancerfonden 19 0008 Pj 01 HLions Cancer Research Foundation 1050097Vetenskapsrådet 2015-02711
6 · The paper itself

Abstract

backgroundHuman papillomavirus (HPV) testing is recommended in primary cervical screening to improve cancer prevention. An advantage of HPV testing is that it can be performed on self-samples, which could increase population coverage and result in a more efficient strategy to identify women at risk of developing cervical cancer. Our objective was to assess whether repeated self-sampling for HPV testing is cost-effective in comparison with Pap smear cytology for detection of cervical intraepithelial neoplasia grade 2 or more (CIN2+) in increasing participation rate in primary cervical screening.

methodsA cost-effectiveness analysis (CEA) was performed on data from a previously published randomized clinical study including 36,390 women aged 30-49 years. Participants were randomized either to perform repeated self-sampling of vaginal fluid for HPV testing (n = 17,997, HPV self-sampling arm) or to midwife-collected Pap smears for cytological analysis (n = 18,393, Pap smear arm).

resultsSelf-sampling for HPV testing led to 1633 more screened women and 107 more histologically diagnosed CIN2+ at a lower cost vs. midwife-collected Pap smears (€ 229,446 vs. € 782,772).

conclusionsThis study resulted in that repeated self-sampling for HPV testing increased participation and detection of CIN2+ at a lower cost than midwife-collected Pap smears in primary cervical screening. Offering women a home-based self-sampling may therefore be a more cost-effective alternative than clinic-based screening.

trial registrationNot registered since this trial is a secondary analysis of an earlier published study (Gustavsson et al., British journal of cancer. 118:896-904, 2018).

Indexed as

Cost-Benefit AnalysisAdultEarly Detection of CancerFemaleFollow-Up StudiesHumansMiddle AgedPapillomaviridaePapillomavirus InfectionsPrognosisRetrospective StudiesSelf CareSpecimen HandlingUterine Cervical DysplasiaUterine Cervical NeoplasmsCervical cancerCIN2 +Cost-effectivenessHPV testingPrecancerous lesionPrimary cervical screeningSelf-sampling

Identifiers

PMID32660432
PMCPMC7359275

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Registered trials

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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.