Table 7 Prevention strategies
Kulasingam 2003 [27] | Sanders 2003 [28] | Goldie 2004 [29] | Taira 2004 [32] | Kulasingam 2007 [39] | |
Strategy assessed | .No Intervention .Vaccination only (12 F) .Cytology 18 F - 5y . Cytology 18 F - 3y . Cytology 18 F - 2y . Cytology 18 F - 1y .Vaccination (12 F) + Cytology 30 F - 5y .Vaccination (12 F) + Cytology 18 F - 5y .Vaccination (12 F) + Cytology 26 F - 3y .Vaccination (12 F) + Cytology 18 F - 3y .Vaccination (12 F) + Cytology 24 F - 2y .Vaccination (12 F) + Cytology 18 F - 2y .Vaccination (12 F) + Cytology 22 F - 1y .Vaccination (12 F) + Cytology 18 F - 1y | .Cytology (16 F) - 2y (.Vaccination (12 F) + Cytology (16 F) - 1y) .Vaccination (12 F) + Cytology (16 F) - 2y (.Vaccination (12 F) + Cytology (16 F) - 3y .Vaccination (12 F) + Cytology (16 F) - 4y .Vaccination (12 F) + Cytology (16 F) - 5y) | .No intervention .Cytology 35 F - 5y .Cytology 30 F - 5y .Cytology 25 F - 5y .Vaccination (12 F) + Cytology 35 F - 5y .Vaccination (12 F) + Cytology 30 F - 5y .Vaccination (12 F) + Cytology 25 F - 5y .Vaccination (12 F) + Cytology 21 F - 5y .Vaccination (12 F) + Cytology 25 F - 3y .Vaccination (12 F) + Cytology 21 F - 3y .Vaccination (12 F) + Cytology 21 F - 2y .Vaccination (12 F) + Cytology 18 F - 2y .Vaccination (12 F) + Cytology LBC 18 F - 2y .Vaccination (12 F) + Cytology 18 F - 1y .Vaccination (12 F) + Cytology LBC 18 F - 1y | . Cytology ?F - 2y (.Vaccination (12 F) + Cytology ?F - 4y .Vaccination (12 F) + Cytology ?F - 3y)) .Vaccination (12 F) + Cytology ?F - 2y (.Vaccination (12 F) + Cytology ?F - 1y) | .No intervention .Vaccination only (12 F) .Cytology 18-21 F - 2y .Vaccination (12 F) + Cytology 18-21 F - 2y .Vaccination (12 F) + Cytology 18-21 F - 3y .Vaccination (12 F) + Cytology 25 F - 3y |
Results | ICER/life year gained, reduction in cervical cancer incidence and mortality | ICER/QALY gained, reduction in cervical cancer incidence and mortality | ICER/QALY gained, reduction in lifetime risk of cervical cancer | ICER/QALY gained | ICER/life year gained |
Goldhaber-Fiebert 2008 [33] | Kim 2008 [31] | Coupe, de Melker 2009 [35] | Coupe, van Ginkel 2009 [36] | Kim 2009 [30] | |
Strategy assessed | .No intervention .Vaccination only (9 F) .Cytology 18 F,21 F,25 F – 5y,3y,2y,1y + HPV triage (Switch 25y,30y,35y) .HPV 18 F - 1y + Cytology triage .Vaccination (9 F) + Cytology 18 F,21 F,25 F – 5y,3y,2y,1y + HPV triage (Switch none, 25y,30y,35y) .Vaccination (9 F) + HPV 25 F - 3y + Cytology triage | .Cytology 20 F - 1y .Cytology 20 F - 2y .Cytology 20 F - 3y + HPV Triage .Vaccination (12 F) + Cytology 20 F - 1y .Vaccination (12 F) + Cytology 20 F - 2y .Vaccination (12 F) + Cytology 20 F - 3y + HPV Triage | .Vaccination only (12 F) .Cytology 30 F,35 F - 4,5,6,7 rounds .Cytology + HPV triage 30 F,35 F - 4,5,6,7 rounds .HPV + Cytology triage 30 F,35 F - 4,5,6,7 rounds .Cytology & HPV 30 F,35 F - 4,5,6,7 rounds | .Cytology 30 F - 5y .Vaccination (12 F) + Cytology 30 F - 5y | .Cytology 25 F/M - 3y + HVP triage .Vaccination (12 F) + Cytology 25 F/M - 3y + HVP triage .Cytology 25 F/M - 2y + HVP triage .Vaccination 12 F/M + Cytology 25 F/M - 3y + HVP triage .Vaccination 12 F + Cytology 25 F/M - 2y + HVP triage .Vaccination 12 F/M + Cytology 25 F/M - 2y + HVP triage |
Results | ICER/QALY gained, reductions in cervical cancer | ICER/QALY gained, reductions in cervical cancer | ICER/QALY gained, cervical cancer cases and cervical cancer deaths avoid | ICER/QALY gained, cervical cancer cases and cervical cancer deaths avoid | ICER/QALY gained, |
Kim, Ortendahl 2009 [34] | Accetta 2010 [38] | Diaz 2010 [43] | Demarteau 2011 [41] | Burger 2012 [42] | |
Strategy assessed | .Cytology + HPV triage lifetime for 35 F every 1y, 2y, 3y, 4y .Cytology + HPV triage + Combined cytology/HPV after 35 F every 1y, 2y, 3y, 4y .Cytology + HPV triage lifetime for 45 F every 1y, 2y, 3y, 4y .Cytology + HPV triage + Combined cytology/HPV after 45 F every 1y, 2y, 3y, 4y | .No intervention .Cytology 25 F - 3y .Cytology 25 F - 5y .HPV DNA 25 F - 3y .HPV DNA 25 F - 5y .Cytology 25 F - 3y + HPV triage .Cytology 25 F - 5y + HPV triage .HPV DNA 25 F - 3y + Pap Triage .HPV DNA 25 F - 5y + Pap Triage .Vaccination only (11 F) .Vaccination (11 F) + Cytology 25 F - 3y .Vaccination (11 F) + Cytology 25 F - 5y .Vaccination (11 F) + HPV DNA 25 F - 3y .Vaccination (11 F) + HPV DNA 25 F - 5y .Vaccination (11 F) + Cytology 25 F - 3y + HPV triage .Vaccination (11 F) + Cytology 25 F - 5y + HPV triage .Vaccination (11 F) + HPV DNA 25 F - 3y + Pap Triage .Vaccination (11 F) + HPV DNA 25 F - 5y + Pap Triage | .Cytology alone .Cytology with HPV triage .Combined cytology and HPV .Vaccination + cytology alone .Vaccination + cytology with HPV triage .Vaccination + combined cytology and HPV | .Cytology ?F – 3y .Vaccination (12 F) + Cytology ?F – 3y (.Cytology ?F – 1y .Vaccination (12 F) + Cytology ?F – 1y .Cytology ?F – 5y .Vaccination (12 F) + Cytology ?F – 5y) | .No vaccinated .Vaccinated only (12 F) .Screening frequency 3y to 6y, wait time for rescreen 6 m or 12 m, additional HPV+/Cyt- 1 to 3 |
Results | ICER/QALY gained, reductions in lifetime risk of cervical cancer | ICER/life year gained, lifetime risk of cervical cancer, reduction in cancer risk, cervical cancer mortality | ICER/life year gained, reduction in cervical cancer | ICER/QALY gained | ICER/life year gained, reduction in cancer |
Coupe 2012 [37] | Tully 2012 [40] | Berkhof 2013 [44] | |||
Strategy assessed | .Cytology 30 F - 5y .Vaccination only .Vaccination + Cytology 30 F-7 times .Vaccination + Cytology 30 F-6 times .Vaccination + Cytology 30 F-5 times .Vaccination + Cytology 30 F-4 times .Vaccination + HPV DNA screening-7 times + cytological triage .Vaccination + HPV DNA screening-6 times + cytological triage .Vaccination + HPV DNA screening-5 times + cytological triage .Vaccination + HPV DNA screening-4 times + cytological triage | .Vaccination (12 F) + Cytology 21 F .Vaccination (12 F) + Cytology 25 F | .Vaccination only (12 F) .10,6,3-yearly Pap .10,6,3-yearly HPV .Vaccination (12 F) +10-yearly Pap .Vaccination (12 F) +10-yearly HPV .Vaccination (12 F) +6-yearly Pap .Vaccination (12 F) +6-yearly HPV | ||
Results | ICER/QALY gained, cancer cases and deaths | ICER/QALY gained, ICER/life year gained | ICER/QALY gained |