Table 1.

Base case parameters and sensitivity analysis parameters used in modeling cervical cancer in HIV-infected women

	Base case		One-way sensitivity analysis	CD4 scenario sensitivity analyses		Source
	CD4 200–500		Min–max	CD4 ≤ 200	CD4 > 500
Start age	38		30–46	N/A	N/A	[7]
Initial prevalence of cancer and pre-cancerous lesions	0.22		0.18–0.27	0.33	0.12	[7]
Initial prevalence
Among cancer/pre-cancerous lesions
Low grade lesions	0		N/A	N/A	N/A	[12, 23]
High grade lesions	0.952		0.762–1	N/A	1
Local cancer	0.020		0.016–0.024	N/A	0
Regional cancer	0.024		0.019–0.029	N/A	0
Distant cancer	0.004		0.003–0.005	N/A	0
Among normal
Low grade lesions	0.098		0.078–0.118	0.169	0.025	[23]
Normal	0.902		0.722–1	0.832	0.975
Loss-to-follow-up probability
2-visit	0.32		0–0.4	N/A	N/A	[29, 52]
3-visit	0.48		0.3–0.6	N/A	N/A	[29, 52]
Standardized mortality ratio for treated HIV-infected patients compared to HIV negative	1.77		1.42–2.12	2.54	1	[53]
Untreated cancer parameter
Cancer mortality probability (monthly)
Local	0.004		0.003–0.005	N/A	N/A	[24]
Regional	0.021		0.017–0.025	N/A	N/A
Distant	0.063		0.051–0.076	N/A	N/A
Progression probability (monthly)
Normal to low grade lesions	0.001		0.000–0.002	N/A	0.000	[23, 24]
Low grade to high grade lesions	0.003		0.002–0.004	N/A	0.001
High grade lesions to local invasive cancer	0.002		0.001–0.003	N/A	0.002
Local to regional invasive cancer	0.003		0.002–0.004	N/A	N/A
Regional to distant invasive cancer	0.003		0.002–0.004	N/A	N/A
Regression probability (monthly)
Low grade lesions to normal	0.003		0.002–0.004	N/A	N/A	[24]
High grade to low grade lesions	0.000		0.000–0.001	N/A	N/A
High grade lesions to normal	0.000		0.000–0.001	N/A	N/A
Treated cancer parameters
Treatment effectiveness (mortality, progression, lesion regression)	0.9		0.7–1	N/A	N/A	[11]
Treated cancer cure probability (monthly)	0.15		0.12–0.18	N/A	N/A	[12]
Side effect probability (monthly)	0.01		0.00–0.02	N/A	N/A	[13]
Probability side effect is Major	0.16		0.13–0.20	N/A	N/A
Sensitivity						[7]
Pap	0.74		0.59–0.89	0.76	0.61
VIA	0.61		0.49–0.73	0.76	0.52
HPV	0.81		0.65–0.97	0.92	0.83
VIA + HPV	0.58		0.46–0.70	N/A	N/A
VIA + Pap	0.51		0.41–0.61	N/A	N/A
HPV + Pap	0.63		0.50–0.76	N/A	N/A
Specificity						[7]
Pap	0.98		0.78–1	0.93	0.98
VIA	0.63		0.50–0.76	0.62	0.73
HPV	0.55		0.44–0.66	0.46	0.62
VIA + HPV	0.84		0.67–1	N/A	N/A
VIA + Pap	0.99		0.79–1	N/A	N/A
HPV + Pap	0.99		0.79–1	N/A	N/A

Costs (2014 USD)	Societal perspective	Clinic perspective
Screening						[31]
PAP	$39	$24	$31–$47	N/A	N/A
VIA	$18	$10	$14–$22	N/A	N/A
HPV (CareHPV)	$32	$18	$26–$38	N/A	N/A
Treatment
Cryotherapy	$48	$12	$38–$58	N/A	N/A
Colposcopy	$160	$109	$128–$192	N/A	N/A
LEEP	$86	$20	$69–$103	N/A	N/A
Side effects
Major	$974	$847	$779–$1169	N/A	N/A
Minor	$203	$178	$162–$244	N/A	N/A
Cancer care
Local	$1135	$112	$908–$1362	N/A	N/A
Regional	$6447	$149	$5158–$7736	N/A	N/A
Distant	$5107	$144	$4086–$6128	N/A	N/A
Palliative care	$196	$145	$157–$235	N/A	N/A

min minimum, max maximum, Pap Papanicolaou smear, HPV DNA testing for Human Papilloma Virus, VIA visual inspection of the cervix with acetic acid, LEEP loop electrosurgical excision procedure, N/A not applicable