Figure 4.

Cumulative age of human papillomavirus (HPV) acquisition in the context of imperfect compliance to US screening guidelines and natural history for four Cancer Intervention and Surveillance Modeling Network modeling groups. Projections of the casual age of infection under assumptions of imperfect screening (blue) are compared with natural history (red) for A) Harvard, B) Microsimulation Screening Analysis (MISCAN)-Cervix, C) Policy1-Cervix, and D) University of Minnesota-HPV Cancer (UMN-HPV CA). For the imperfect compliance scenario, we assumed 70% compliance with primary testing and 90% compliance with follow-up management as recommended, including diagnostic colposcopy or biopsy and treatment to remove high-grade lesions. Shaded area for the Harvard model represents the upper and lower bounds across the 50 good-fitting natural history parameter sets.