Rapid elimination of cervical cancer while maintaining the harms and benefits ratio of cervical cancer screening: a modelling study

Table 2 Optimal screening strategies that reach elimination first without exceeding the current NNR, by vaccination scenario

Vaccination scenario		Screening strategy for vaccinated cohorts^b		Elimination year (years of delay^c)	Cervical cancer deaths per 100,000 person years over 2022–2100
Coverage^a	Vaccine type	Number of lifetime screens	Coverage (%)	Elimination year (years of delay^c)	Optimal strategy	Difference with base case scenario^d
90%^e	9 V	2^f	70	2040 (2)	1.21	− 0.34 (− 22%)
90%	9 V	2^f	70	2040 (1)	1.24	− 0.32 (− 20%)
80%	9 V	2^f	70	2040 (0)	1.27	− 0.29 (− 19%)
70%	9 V	2^f	70	2041 (1)	1.31	− 0.25 (− 16%)
60%	9 V	1^f	70	2041 (1)	1.38	− 0.17 (− 11%)
55%	9 V	1^f	70	2042 (2)	1.44	− 0.11 (− 7%)
90%^e	2 V	1^f	70	2040 (0)	1.53	− 0.03 (− 2%)
90%	2 V	1^f	70	2042 (2)	1.55	− 0.01 (− 1%)
80%	2 V	1^f	61	2042 (2)	1.60	+ 0.04 (3%)
70%	2 V	3	70	2043 (3)	1.54	− 0.02 (− 1%)
60%	2 V	3	70	2043 (3)	1.60	+ 0.04 (3%)
55%	2 V	3	70	2043 (3)	1.64	+ 0.08 (5%)

^a Vaccination coverage in girls. Coverage in boys is assumed to be 50% of that in girls unless indicated otherwise
^b Unvaccinated cohorts are screened according to the current guidelines
^c Years of delay compared with the most intense screening strategy (five lifetime screens for all women and 70% screening coverage)
^d In the base case scenario vaccination coverage is 55% with the bivalent vaccine. Women receive 5 lifetime screening invitations and screening coverage is 61%
^e 90% coverage in both boys and girls
^f Women in vaccinated cohorts that did not receive vaccination are screened to the current guidelines
9 V, nonavalent vaccine; 2 V, bivalent vaccine; NNR, number needed to refer to prevent 1 cervical cancer death

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