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Current Oncology
Volume 23
Issue s1
10.3747/co.23.2991
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Current Oncology is published by MDPI from Volume 28 Issue 1 (2021). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with Multimed Inc..
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Article

Using the Cancer Risk Management Model to Evaluate the Health and Economic Impacts of Cytology Compared with Human Papillomavirus DNA Testing for Primary Cervical Cancer Screening in Canada

by
C. Popadiuk
1,*,
C.L. Gauvreau
2,
M. Bhavsar
2,
C. Nadeau
3,
K. Asakawa
3,
W.M. Flanagan
3,
M.C. Wolfson
4,
A.J. Coldman
2,
S. Memon
2,
N. Fitzgerald
2,
J. Lacombe
2 and
A.B. Miller
5
1
Department of Women’s Health, Memorial University, St. John’s, NL, Canada
2
Canadian Partnership Against Cancer, Toronto, ON, Canada
3
Statistics Canada, Ottawa, ON, Canada
4
University of Ottawa, Ottawa, ON, Canada
5
Dalla Lana School of Public Health, Toronto, ON, Canada
*
Author to whom correspondence should be addressed.
Curr. Oncol. 2016, 23(s1), 56-63; https://doi.org/10.3747/co.23.2991
Submission received: 11 November 2015 / Revised: 14 December 2015 / Accepted: 12 January 2016 / Published: 1 February 2016

Abstract

Background: In Canada, discussion about changing from cytology to human papillomavirus (HPV) DNA testing for primary screening in cervical cancer is ongoing. However, the Canadian Task Force on Preventive Health Care has not yet made a recommendation, concluding that the evidence is insufficient. Methods: We used the cervical cancer and HPV transmission models of the Cancer Risk Management Model to study the health and economic outcomes of primary cytology compared with HPV DNA testing in 14 screening scenarios with varying screening modalities and intervals. Projected cervical cancer cases, deaths, colposcopies, screens, costs, and incremental cost-effectiveness were evaluated. We performed sensitivity analyses for HPV DNA test costs. Results: Compared with triennial cytology from age 25, 5-yearly HPV DNA screening alone from age 30 resulted in equivalent incident cases and deaths, but 55% (82,000) fewer colposcopies and 43% (1,195,000) fewer screens. At HPV DNA screening intervals of 3 years, whether alone or in an age-based sequence with cytology, screening costs are greater, but at intervals of more than 5 years, they are lower. Scenarios on the cost-effectiveness frontier were HPV DNA testing alone every 10, 7.5, 5, or 3 years, and triennial cytology starting at age 21 or 25 when combined with HPV DNA testing every 3 years. Conclusions: Changing from cytology to HPV DNA testing as the primary screening test for cervical cancer would be an acceptable strategy in Canada with respect to incidence, mortality, screening and diagnostic test volumes.
Keywords: Human papillomavirus; cervical cancer; screening; cytology; hpv dna; modelling; Canada Human papillomavirus; cervical cancer; screening; cytology; hpv dna; modelling; Canada

Share and Cite

MDPI and ACS Style

Popadiuk, C.; Gauvreau, C.L.; Bhavsar, M.; Nadeau, C.; Asakawa, K.; Flanagan, W.M.; Wolfson, M.C.; Coldman, A.J.; Memon, S.; Fitzgerald, N.; et al. Using the Cancer Risk Management Model to Evaluate the Health and Economic Impacts of Cytology Compared with Human Papillomavirus DNA Testing for Primary Cervical Cancer Screening in Canada. Curr. Oncol. 2016, 23, 56-63. https://doi.org/10.3747/co.23.2991

AMA Style

Popadiuk C, Gauvreau CL, Bhavsar M, Nadeau C, Asakawa K, Flanagan WM, Wolfson MC, Coldman AJ, Memon S, Fitzgerald N, et al. Using the Cancer Risk Management Model to Evaluate the Health and Economic Impacts of Cytology Compared with Human Papillomavirus DNA Testing for Primary Cervical Cancer Screening in Canada. Current Oncology. 2016; 23(s1):56-63. https://doi.org/10.3747/co.23.2991

Chicago/Turabian Style

Popadiuk, C., C.L. Gauvreau, M. Bhavsar, C. Nadeau, K. Asakawa, W.M. Flanagan, M.C. Wolfson, A.J. Coldman, S. Memon, N. Fitzgerald, and et al. 2016. "Using the Cancer Risk Management Model to Evaluate the Health and Economic Impacts of Cytology Compared with Human Papillomavirus DNA Testing for Primary Cervical Cancer Screening in Canada" Current Oncology 23, no. s1: 56-63. https://doi.org/10.3747/co.23.2991

APA Style

Popadiuk, C., Gauvreau, C. L., Bhavsar, M., Nadeau, C., Asakawa, K., Flanagan, W. M., Wolfson, M. C., Coldman, A. J., Memon, S., Fitzgerald, N., Lacombe, J., & Miller, A. B. (2016). Using the Cancer Risk Management Model to Evaluate the Health and Economic Impacts of Cytology Compared with Human Papillomavirus DNA Testing for Primary Cervical Cancer Screening in Canada. Current Oncology, 23(s1), 56-63. https://doi.org/10.3747/co.23.2991

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