Budget impact analysis of cervical cancer screening in Portugal: comparison of cytology and primary HPV screening strategies

Pista, Angela; Costa, Carlos; Saldanha, Conceição; Moutinho, José Alberto Fonseca; Moutinho, José Maria; Arrobas, Fernando; Catalão, Carlos; Kempers, Jari

doi:10.1186/s12889-019-6536-4

Table 1 Annual transition (progression / regression) probabilities of the Markov model; Natural history inputs for HPV infection, CIN, and cervical cancer

From: Budget impact analysis of cervical cancer screening in Portugal: comparison of cytology and primary HPV screening strategies

	Model input	References
Annual Progressio
Well to hrHPV infection	4.2%	Kulasingam et al. (2011) [10]
Progression from hrHPV (12 types)
to CIN1	8.1%	Kulasingam et al. (2011) [10]; Insinga RP et al. (2007) [11]
to CIN2	0.1%	Khan MJ et al. (2005) [12]
to CIN3	0.1%	Khan MJ et al. (2005) [12]
Progression from hrHPV 16/18
to CIN1	9.9%	Insinga RP et al. (2007) [11]; Insinga RP et al. (2009) [13]
to CIN2	0.6%	Khan MJ et al. (2005) [12]
to CIN3	1.5%	Khan MJ et al. (2005) [12]
Progression from CIN1
to CIN2	3.2%	Weighted average: Kataja V et al. (1989) [14]; Holowaty P et al. (1999) [15]; Matsumoto K et al. (2006) [16]; Omori M et al. (2007) [17]; Guedes AC et al. (2010) [18]
to CIN3	0.9%
to CxCa	0.3%
Progression from CIN2
to CIN3	4.2%	Weighted average: Kataja V et al. (1989) [14]; Holowaty P et al. (1999) [15]; Matsumoto K et al. (2006) [16]; Omori M et al. (2007) [17]; Guedes AC et al. (2010) [18]
to CxCa	1.8%
CIN3 to CxCa	3.4%	Weighted average: Kataja V et al. (1989) [14]; Holowaty P et al. (1999) [15]; McCredie et al. (2008) [19]
Annual mortality rate for CxCa	0.6%	SEER data. 5 year survival of 68% converted to annual mortality rate [20]
Annual Regression
Regression from hrHPV (12 types)
with normal cytology to well	58.6%	Bulkmans NJ et al. (2007) [21]
with borderline/mild cytology to well	45.6%	Bulkmans NJ et al. (2007) [21]
Regression from hrHPV 16/18
with normal cytology to well	43.8%	Bulkmans NJ et al. (2007) [21]
with borderline/mild cytology to well	21.8%	Bulkmans NJ et al. (2007) [21]
Regression from CIN1
to well	21.2%	Weighted average: Kataja V et al. (1989) [14]; Holowaty P et al. (1999) [15]; Matsumoto K et al. (2010) [22]
to hrHPV	2.4%
Regression from CIN2
to well	9.4%	Weighted average: Kataja V et al. (1989) [14]; Meyskens FL Jr. et al. (1994) [23]; Holowaty P et al. (1999) [15]; Matsumoto K et al. (2006) [16]; Omori M et al. (2007) [17]; Castle PE et al. (2009) [24]; Guedes AC et al. (2010) [18]
to CIN1	9.4%
Regression from CIN3
to well	3.9%	Weighted average: Kataja V et al. (1989) [14]; McCredie et al. (2008) [19]
to CIN1	1.6%

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