Parameter | CIN1 Base case (95%CI) | CIN2 Base case (95%CI) | CIN3 Base case (95%CI) | Distribution | Source |
---|---|---|---|---|---|
Efficacy of screening strategies | |||||
Self-HPV without triage | [9] | ||||
Sensitivity | 0.70(0.61–0.77) | 0.84(0.76–0.89) | 0.85(0.75–0.91) | Beta | |
Specificity | 0.83(0.82–0.84) | 0.82(0.81–0.83) | 0.81(0.80–0.82) | Beta | |
Self-HPV16/18 triage | |||||
Sensitivity | 0.41(0.32–0.52) | 0.67(0.57–0.75) | 0.72(0.61–0.82) | Beta | |
Specificity | 0.97(0.96–0.97) | 0.96(0.96–0.97) | 0.95(0.95–0.96) | Beta | |
Self-HPV7 types triage | |||||
Sensitivity | 0.60(0.51–0.68) | 0.80(0.72–0.87) | 0.81(0.70–0.88) | Beta | |
Specificity | 0.89(0.88–0.90) | 0.88(0.88–0.89) | 0.88(0.87–0.88) | Beta | |
Physician-HPV without triage | |||||
Sensitivity | 0.76(0.53–0.90) | 0.84(0.62–0.94) | 0.90(0.74–0.97) | Beta | |
Specificity | 0.82(0.80–0.83) | 0.81(0.80–0.83) | 0.81(0.79–0.82) | Beta | |
Physician-HPV16/18 triage | |||||
Sensitivity | 0.59(0.36–0.78) | 0.53(0.32–0.73) | 0.76(0.56–0.88) | Beta | |
Specificity | 0.96(0.95–0.97) | 0.95(0.94–0.96) | 0.95(0.94–0.96) | Beta | |
Physician-HPV7 types triage | |||||
Sensitivity | 0.65(0.41–0.83) | 0.84(0.62–0.94) | 0.86(0.69–0.95) | Beta | |
Specificity | 0.88(0.86–0.89) | 0.87(0.86–0.89) | 0.86(0.85–0.88) | Beta | |
Physician-HPV with genotype triage | |||||
Sensitivity | 0.81(0.57–0.93) | 0.98(0.89–1.00) | 0.97(0.83–0.99) | Beta | |
Specificity | 0.59(0.54–0.64) | 0.57(0.52–0.62) | 0.54(0.49–0.59) | Beta | |
Physician-HPV with cytology triage | |||||
Sensitivity | 0.50(0.28–0.72) | 0.84(0.62–0.94) | 0.82(0.64–0.92) | Beta | |
Specificity | 0.66(0.61–0.71) | 0.66(0.61–0.70) | 0.63(0.58–0.68) | Beta | |
Participation variables | Base case (Range) | ||||
Participation of physician-sampling | 0.70(0.25–1.00) | Beta | Assumed | ||
RR (self-sampling participation vs physician-sampling) | 1.28(0.90–1.82) | Ln (RR) is normal | [28] | ||
Loss to follow-up (per visit) | 0.15(0.00–0.50) | Beta | [29] | ||
Treatment efficacy | |||||
Thermal ablation for HPV positive | 0.804(0.734–0.859) | Beta | [10] | ||
Thermal ablation for CIN 1 | 0.903(0.805–0.955) | Beta | [10] | ||
Thermal ablation for CIN 2/3 | 0.762(0.615–0.865) | Beta | [10] | ||
LEEP for HPV positive | / | ||||
LEEP for CIN 2/3 | 0.947(0.931–0.963) | Beta | [33] | ||
Eligibility for thermal ablation | |||||
HPV positive, without CIN | 0.456(0.342–0.570) | Beta | |||
CIN 1 | 0.510(0.383–0.638) | Beta | |||
CIN 2 | 0.534(0.400–0.667) | Beta | |||
CIN 3 | 0.449(0.337–0.561) | Beta | |||
Precancer management for current strategies | |||||
Urban area | |||||
Follow up and management for CIN 1 | 0.905(0.815–0.996) | Beta | |||
Treatment of CIN2/3 | 0.953(0.858–1.000) | Beta | |||
Rural area | |||||
Follow up and management for CIN 1 | 0.841(0.757–0.925) | Beta | |||
Treatment of CIN2/3 | 0.895(0.805–0.984) | Beta | |||
Treatment costs (2020 US$) | |||||
TA | 11.43(± 25%) | Gamma | Micro-costing approach | ||
LEEP | 155.63(± 25%) | Gamma | [36] | ||
Costs of cervical cancer treatment (2020 US$) | |||||
Urban area | |||||
CC FIGOI-IIa treatment | 7974.19(± 25%) | Gamma | |||
CC FIGO IIb-IV treatment | 14,051.52(± 25%) | Gamma | |||
Rural area | |||||
CC FIGOI-IIa treatment | 5329.05(± 25%) | Gamma | |||
CC FIGO IIb-IV treatment | 8819.70(± 25%) | Gamma | |||
Follow up cost after treatment (2020 US$) | |||||
Urban area | |||||
TA for self-sampling strategy (HPV positive) | 33.73(± 25%) | Gamma | [10], Micro-costing approach | ||
TA for self-sampling strategy (CIN1 +) | 49.27(± 25%) | Gamma | |||
TA for physician-sampling strategy (HPV positive) | 47.67(± 25%) | Gamma | |||
TA for physician-sampling strategy (CIN1 +) | 64.80(± 25%) | Gamma | |||
LEEP (CIN2 or CIN3) | 106.92(± 25%) | Gamma | |||
Rural area | |||||
TA for self-sampling strategy (HPV positive) | 29.90 (± 25%) | Gamma | [10], Micro-costing approach | ||
TA for self-sampling strategy (CIN1 +) | 45.23 (± 25%) | Gamma | |||
TA for physician-sampling strategy (HPV positive) | 39.17(± 25%) | Gamma | |||
TA for physician-sampling strategy (CIN1 +) | 55.57(± 25%) | Gamma | |||
LEEP (CIN2 or CIN3) | 97.73 (± 25%) | Gamma | |||
Utility | |||||
Utility before thermal ablation | 0.986(0.978–0.994) | Normal | |||
Utility after thermal ablation | |||||
≤ CIN1 | 0.989(0.983–0.996) | Normal | |||
CIN2 + | 0.965(0.930–0.999) | Normal | |||
Utility before LEEP | 0.984(0.977–0.992) | Normal | |||
Utility after LEEP | 0.956(0.938–0.974) | Normal |