التفاصيل البيبلوغرافية
| العنوان: |
Optimal Management Strategies for Primary HPV Testing for Cervical Screening: Cost-Effectiveness Evaluation for the National Cervical Screening Program in Australia |
| المؤلفون: |
Simms, KT, Hall, M, Smith, MA, Lew, J-B, Hughes, S, Yuill, S, Hammond, I, Saville, M, Canfell, K |
| المساهمون: |
Chan, KYK |
| بيانات النشر: |
PUBLIC LIBRARY SCIENCE |
| سنة النشر: |
2017 |
| المجموعة: |
The University of Melbourne: Digital Repository |
| الوصف: |
BACKGROUND: Several countries are implementing a transition to HPV testing for cervical screening in response to the introduction of HPV vaccination and evidence indicating that HPV screening is more effective than cytology. In Australia, a 2017 transition from 2-yearly conventional cytology in 18-20 to 69 years to 5-yearly primary HPV screening in 25 to 74 years will involve partial genotyping for HPV 16/18 with direct referral to colposcopy for this higher risk group. The objective of this study was to determine the optimal management of women positive for other high-risk HPV types (not 16/18) ('OHR HPV'). METHODS: We used a dynamic model of HPV transmission, vaccination, natural history and cervical screening to determine the optimal management of women positive for OHR HPV. We assumed cytology triage testing was used to inform management in this group and that those with high-grade cytology would be referred to colposcopy and those with negative cytology would receive 12-month surveillance. For those with OHR HPV and low-grade cytology (considered to be a single low-grade category in Australia incorporating ASC-US and LSIL), we evaluated (1) the 20-year risk of invasive cervical cancer assuming this group are referred for 12-month follow-up vs. colposcopy, and compared this to the risk in women with low-grade cytology under the current program (i.e. an accepted benchmark risk for 12-month follow-up in Australia); (2) the population-level impact of the whole program, assuming this group are referred to 12-month surveillance vs. colposcopy; and (3) the cost-effectiveness of immediate colposcopy compared to 12-month follow-up. Evaluation was performed both for HPV-unvaccinated cohorts and cohorts offered vaccination (coverage ~72%). FINDINGS: The estimated 20-year risk of cervical cancer is ≤1.0% at all ages if this group are referred to colposcopy vs. ≤1.2% if followed-up in 12 months, both of which are lower than the ≤2.6% benchmark risk in women with low-grade cytology in the current program (who are ... |
| نوع الوثيقة: |
article in journal/newspaper |
| اللغة: |
English |
| تدمد: |
1932-6203 |
| Relation: |
pii: PONE-D-16-12831; Simms, K. T., Hall, M., Smith, M. A., Lew, J. -B., Hughes, S., Yuill, S., Hammond, I., Saville, M. & Canfell, K. (2017). Optimal Management Strategies for Primary HPV Testing for Cervical Screening: Cost-Effectiveness Evaluation for the National Cervical Screening Program in Australia. PLOS ONE, 12 (1), https://doi.org/10.1371/journal.pone.0163509.; http://hdl.handle.net/11343/257943 |
| الاتاحة: |
http://hdl.handle.net/11343/257943 |
| Rights: |
CC BY ; https://creativecommons.org/licenses/by/4.0 |
| رقم الانضمام: |
edsbas.C9E31FB1 |
| قاعدة البيانات: |
BASE |
Full Text Finder