Table 2.
Epidemiological data, test accuracies, treatment effectiveness, transitional probabilities, and utilities
| Parameters/Health states | Values | SE | References |
|---|---|---|---|
| Epidemiological data | |||
| Prevalence | |||
| HPV infection at age 25–30 years | 11.7% | 1.9% | Tangjitgamol, 2022 [18] |
| HPV infected but normal pathology | 56.7% | 3.4% | Phoolcharoen, 2017 [19] |
| CIN2+ (included cervical cancer) | 1.7% | 0.3% | Phoolcharoen, 2017 [19] |
| Cervical cancer (per 100 000 women) | 68.6 | 8.3 | Globocan, 2020 [3] |
| Incidence of high-risk HPV infection | 0.0051 | 0.0005 | Shama, 2012 [20] |
| Accuracies of screening tests for detecting CIN2 or worse (%, 95% CI) | |||
| Self-collected samples for HPV DNA testing: relative sensitivity | 0.91 | 0.88, 0.96 | Inturrisi, 2021 [17], Arbyn, 2022 [16] |
| Self-collected samples for HPV DNA testing: relative specificity | 1.02 | 1.01, 1.02 | Inturrisi, 2021 [17], Arbyn, 2022 [16] |
| Clinician-collected samples for HPV DNA testing: sensitivity | 91% | 87, 94 | Arbyn, 2014 [10] |
| Clinician-collected samples for HPV DNA testing: specificity | 88% | 85, 91 | Arbyn, 2014 [10] |
| Clinician-collected samples for cytology test: sensitivity (test cutoff at ASCUS or worse) | 83% | 75, 89 | Arbyn, 2014 [10] |
| Clinician-collected samples for cytology test: specificity (test cutoff at ASCUS or worse) | 91% | 87, 94 | Arbyn, 2014 [10] |
| Treatment effectiveness | |||
| Treatment access rate | 100% | - | Assumption |
| % eligibility for treatment for CIN1 | 90% | - | Campos, 2020 [42] |
| Treatment effectiveness | 88% | 9% | Campos, 2020 [42] |
| Proportion of women retaining HPV infection following treatment | 15% | - | Campos, 2020 [42] |
| Regression rate of CIN2/3 to normal or CIN1/2 with treatment | 0.46 | 0.20 | Tainio, 2018 [24] |
| Transitional probabilities | |||
| Progression of condition/disease | |||
| HPV infected → CIN1 | 0.069 | 0.015 | Praditsitithikorn, 2011 [21] |
| CIN1 → CIN2 | 0.155 | 0.024 | Bekos, 2018 [23] |
| CIN2 → CIN3 | 0.270 | 0.065 | Bekos, 2018 [23] |
| CIN3 → stage 1 | 0.026 | 0.008 | Bekos, 2018 [23] |
|
Stage 1 → stage 2 Probability of recurrence |
0.355 0.010 |
0.296 0.001 |
Praditsitithikorn, 2011 [21] Gomez-Hidalgo, 2022 [22] |
|
Stage 2 → stage 3 Probability of recurrence |
0.415 0.010 |
0.296 0.001 |
Praditsitithikorn, 2011 [21] Gomez-Hidalgo, 2022 [22] |
|
Stage 3 → stage 4 Probability of recurrence |
0.495 0.107 |
0.131 - |
Praditsitithikorn, 2011 [21] Xue, 2018 [25] |
|
Stage 4 Probability of recurrence |
0.234 | - | Scatchard, 2012 [26] |
| Regression of condition/disease | |||
|
HPV infected → normal age 25–29 years age ≥ 30 years |
0.370 0.103 |
0.033 0.018 |
Praditsitithikorn, 2011 [21] |
|
CIN1 → normal age 25–34 years age ≥ 35 years |
0.140 0.071 |
0.022 0.019 |
Praditsitithikorn, 2011 [21], Bekos, 2018 [23] |
|
CIN1 → HPV infected age 25–34 years age ≥ 35 years |
0.021 0.011 |
0.002 0.002 |
Praditsitithikorn, 2011 [21], Bekos, 2018 [23] |
| CIN2/3 → normal or CIN1/2 | 0.069 | 0.013 | Praditsitithikorn, 2011 [21] |
| CIN2/3 → normal or CIN1/2 (with treatment) | 0.411 | 0.113 | Tainio, 2018 [24] |
|
Stage 2 Recurrence 2 → remission 2 |
0.760 | 0.015 | Xue, 2018 [25] |
|
Stage 3 Persistence 3 → remission 3 Remission 3 → remission 3 Recurrence 3 → remission 3 |
0.760 0.850 0.760 |
0.015 0.015 0.015 |
Xue, 2018 [25] Xue, 2018 [25] Xue, 2018 [25] |
|
Stage 4 Recurrence 4 → remission 4 |
0.220 | 0.015 | Scatchard, 2012 [26] |
| Utilities | |||
|
Normal/HPV infected/CIN1 age 25–34 years age 35–44 years age 45–54 years age 55–64 years age ≥ 65 years |
0.91 0.89 0.86 0.80 0.78 |
0.09 0.09 0.09 0.08 0.08 |
Termrungruanglert, 2021 [5] |
|
CIN2-3 age 25–34 years age 35–44 years age ≥ 45 years |
0.91 0.89 0.87 |
0.09 0.09 0.09 |
Termrungruanglert, 2021 [5] |
|
Cervical cancer stage 1 Persistence 1 Remission 1 Recurrence 1 |
0.74 0.80 0.79 0.8 |
0.01 0.20 0.01 0.03 |
Praditsitithikorn, 2011 [21] |
|
Cervical cancer stage 2 Persistence 2 Remission 2 Recurrence 2 |
0.76 0.80 0.79 0.68 |
0.01 0.04 0.01 0.02 |
Praditsitithikorn, 2011 [21] |
|
Cervical cancer stage 3 Persistence 3 Remission 3 Recurrence 3 |
0.72 0.65 0.81 0.66 |
0.02 0.05 0.01 0.04 |
Praditsitithikorn, 2011 [21] |
|
Cervical cancer stage 4 Persistence 4 Remission 4 Recurrence 4 |
0.63 0.45 0.85 0.81 |
0.03 0.05 0.05 0.08 |
Praditsitithikorn, 2011 [21] |
ASCUS, atypical squamous cells of undetermined significance; CIN, cervical intraepithelial neoplasia; HPV DNA, human papillomavirus deoxyribonucleic acid; SE, standard error