Fig. 4

Cost-effectiveness of variants of strategy B2 (HPV + genotyping) that meet WHO’s proposal of screening women between the ages of 35 and 45 years for cohorts implemented with the routine vaccination program (vaccinated cohorts). Using A life years (LYs) and B quality-adjusted life years (QALYs) as metrics for quantifying health outcomes. ^aAssume that 9vHPV vaccines provided lifelong protection and the vaccine uptake was 85%. ^bFollowing the HKCOG guidelines, for strategy B2 (HPV + genotyping), women would start screening with cytology at the age of 25 years and then switch to the primary HPV test after 30 years. For variants of strategy B2 that start screening age at 30 and 35 years, women would directly undergo primary HPV testing at 30 and 35 years, respectively, without the prior cytology screening at age 25–29 years. ^cThe x- and y-axes represent the incremental discounted cost and LY/QALY compared with “no screening.” ^dThe black thick lines are the cost-effectiveness frontiers, with the numbers in round-cornered rectangles representing the ICERs compared to “no screening” (for the first non-dominated strategy, denoted with ^#) or the previous non-dominated strategy