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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%

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%

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%

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%

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%