Evidence map›Paper›PMID 38309749›Full record

ArticleBMJ open2024

Impact of human papillomavirus age-related prevalence and vaccination levels on interpretation of cervical screening modalities: a modelling study.

David Robert Grimes

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Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

Corrections and comments

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5 · Who and what money

Authors and funding

1 author.

David Robert GrimesSchool of Medicine, Trinity College Dublin, Dublin, Ireland davidrobert.grimes@tcd.ie.ORCID 0000-0003-3140-3278

Funding

Wellcome Trust
6 · The paper itself

Abstract

objectiveCervical screening is a life-saving intervention, which reduces the incidence of and mortality from cervical cancer in the population. Human papillomavirus (HPV) based screening modalities hold unique promise in improving screening accuracy. HPV prevalence varies markedly by age, as does resultant cervical intraepithelial neoplasia (CIN), with higher rates recorded in younger women. With the advent of effective vaccination for HPV drastically reducing prevalence of both HPV and CIN, it is critical to model how the accuracy of different screening approaches varies with age cohort and vaccination status. This work establishes a model for the age-specific prevalence of HPV factoring in vaccine coverage and predicts how the accuracy of common screening modalities is affected by age profile and vaccine uptake.

designModelling study of HPV infection rates by age, ascertained from European cohorts prior to the introduction of vaccination. Reductions in HPV due to vaccination were estimated from the bounds predicted from multiple modelling studies, yielding a model for age-varying HPV and CIN grades 2 and above (CIN2+) prevalence.

settingPerformance of both conventional liquid-based cytology (LBC) screening and HPV screening with LBC reflex (HPV reflex) was estimated under different simulated age cohorts and vaccination levels.

participantsSimulated populations of varying age and vaccination status.

resultsHPV-reflex modalities consistently result in much lower incidence of false positives than LBC testing, with an accuracy that improves even as HPV and CIN2+ rates decline.

conclusionsHPV-reflex tests outperform LBC tests across all age profiles, resulting in greater test accuracy. This improvement is especially pronounced as HPV infection rates fall and suggests HPV-reflex modalities are robust to future changes in the epidemiology of HPV.

Indexed as

Papillomavirus InfectionsPapillomavirus VaccinesUterine Cervical DysplasiaUterine Cervical NeoplasmsEarly Detection of CancerFemaleHuman Papillomavirus VirusesHumansMass ScreeningPrevalenceVaccinationPapillomavirus VaccinesMass ScreeningPublic healthPUBLIC HEALTHSexually Transmitted Disease

Identifiers

PMID38309749
PMCPMC10840029

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