Table 1.
Projected age‐standardized cervical cancer incidence and time to elimination under modelled scenarios for all women, women living without HIV and women living with HIV
| Age‐standardized a cervical cancer incidence (per 100K) Median (range) b | Year elimination threshold reached c Median (range) b | ||||
|---|---|---|---|---|---|
| Year 2030 (after 10 years) | Year 2070 (after 50 years) | Year 2120 (after 100 years) | <10/100K | <4/100K | |
| All women | |||||
| Three‐visit screening and treatment between ages 35 and 39 | |||||
| Baseline (cytology with colposcopy triage) | 71.3 (50.4, 106.4) | 20.5 (10.3, 39.3) | 10.7 (4.2, 29.9) | X (2071, X) | X (X, X) |
| Baseline with vaccine scale‐up d | 70.9 (50.1, 105.8) | 12.1 (6.2, 21.0) | 6.3 (3.3, 13.6) | 2076 (2060, X) | X (2096, X) |
| Single‐visit interventions between ages 35 and 39 | |||||
| HPV DNA testing | 67.2 (47.5, 98.4) | 9.9 (5.1, 16.9) | 5.3 (2.8, 11.8) | 2070 (2056, X) | X (2081, X) |
| HPV DNA genotyping | 67.9 (48.0, 99.7) | 11.0 (6.0, 19.6) | 6.5 (3.4, 14.1) | 2073 (2058, X) | X (2099, X) |
| AVE | 67.3 (47.6, 98.3) | 10.0 (5.2, 17.1) | 5.5 (2.9, 11.9) | 2070 (2056, X) | X (2082, X) |
| HPV DNA with AVE triage | 67.7 (47.9, 99.3) | 10.3 (5.3, 17.6) | 5.6 (2.9, 12.2) | 2071 (2057, X) | X (2084, X) |
| Single‐visit interventions at ages 35–39 and 45–59 | |||||
| HPV DNA testing | 58.7 (41.9, 84.9) | 7.8 (4.1, 13.7) | 4.3 (2.4, 10.1) | 2064 (2052, X) | X (2072, X) |
| HPV DNA genotyping | 60.8 (43.3, 88.2) | 9.8 (5.6, 18.3) | 6.5 (3.3, 14.1) | 2070 (2055, X) | X (2096, X) |
| AVE | 58.8 (42.1, 840) | 7.9 (4.2, 13.8) | 4.6 (2.5, 10.2) | 2065 (2052, X) | X (2072, X) |
| HPV DNA with AVE triage | 60.1 (42.9, 86.5) | 8.4 (4.4, 14.6) | 4.8 (2.6, 10.7) | 2066 (2053, X) | X (2074, X) |
| Single‐visit interventions with HIV‐targeted screening e | |||||
| HPV DNA testing | 48.9 (35.2, 69.6) | 5.5 (3.0, 10.6) | 3.7 (1.8, 8.6) | 2057 (2047, 2074) | 2095 (2061, X) |
| HPV DNA genotyping | 52.7 (37.5, 75.1) | 8.8 (5.2, 17.0) | 6.5 (3.3, 14.1) | 2065 (2051, X) | X (2093, X) |
| AVE | 49.3 (35.8, 69.7) | 5.7 (3.1, 11.0) | 4.0 (2.0, 8.9) | 2058 (2047, 2077) | 2114 (2062, X) |
| HPV DNA with AVE triage | 51.4 (37.0, 72.3) | 6.2 (3.4, 11.8) | 4.2 (2.1, 9.4) | 2060 (2048, 2085) | X (2064, X) |
| Women without HIV | |||||
| Three‐visit screening and treatment between ages 35 and 39 | |||||
| Baseline (cytology with colposcopy triage) | 32.8 (15.7, 51.3) | 10.9 (4.5, 23.8) | 6.3 (2.2, 18.9) | 2074 (2046, X) | X (2075, X) |
| Baseline with vaccine scale‐up d | 32.4 (15.5, 50.9) | 6.1 (2.7, 12.3) | 4.1 (1.7, 9.3) | 2058 (2042, 2085) | X (2059, X) |
| Single‐visit interventions between ages 35 and 39 | |||||
| HPV DNA testing | 31.1 (14.8, 47.6) | 5.1 (2.3, 10.4) | 3.5 (1.5, 8.2) | 2055 (2040, 2072) | 2083 (2056, X) |
| HPV DNA genotyping | 31.4 (14.9, 48.2) | 5.7 (2.7, 12.0) | 4.3 (1.8, 9.6) | 2056 (2040, 2090) | X (2057, X) |
| AVE | 31.0 (14.7, 47.4) | 5.2 (2.3, 10.5) | 3.6 (1.6, 8.2) | 2055 (2040, 2073) | 2088 (2056, X) |
| HPV DNA with AVE triage | 31.3 (14.9, 48.1) | 5.4 (2.4, 10.8) | 3.7 (1.6, 8.4) | 2056 (2040, 2074) | 2092 (2056, X) |
| Single‐visit interventions at ages 35–39 and 45–59 | |||||
| HPV DNA testing | 27.8 (13.1, 41.7) | 4.0 (1.8, 8.5) | 3.1 (1.3, 7.0) | 2051 (2037, 2064) | 2071 (2051, X) |
| HPV DNA genotyping | 28.5 (13.5, 43.1) | 5.5 (2.5, 11.3) | 4.3 (1.8, 9.6) | 2054 (2038, 2087) | X (2055, X) |
| AVE | 27.6 (13.0, 41.0) | 4.2 (1.9, 8.5) | 3.1 (1.4, 7.1) | 2051 (2036, 2064) | 2073 (2051, X) |
| HPV DNA with AVE triage | 28.4 (13.4, 42.6) | 4.5 (2.0, 9.1) | 3.2 (1.4, 7.4) | 2052 (2037, 2066) | 2075 (2052, X) |
| Single‐visit interventions with HIV‐targeted screening e | |||||
| HPV DNA testing | 27.5 (13.0, 41.4) | 3.7 (1.7, 8.0) | 3.0 (1.2, 6.9) | 2050 (2036, 2062) | 2068 (2050, X) |
| HPV DNA genotyping | 28.2 (13.4, 42.9) | 5.3 (2.5, 11.0) | 4.3 (1.8, 9.6) | 2053 (2037, 2085) | X (2054, X) |
| AVE | 27.4 (12.9, 40.8) | 4.0 (1.8, 8.2) | 3.1 (1.3, 7.0) | 2051 (2036, 2063) | 2071 (2050, X) |
| HPV DNA with AVE triage | 28.3 (13.3, 42.4) | 4.3 (1.9, 8.7) | 3.2 (1.3, 7.3) | 2052 (2037, 2065) | 2073 (2052, X) |
| Women with HIV | |||||
| Three‐visit screening and treatment between ages 35 and 39 | |||||
| Baseline (cytology with colposcopy triage) | 158.1 (116.0, 244.8) | 48.1 (24.6, 98.5) | 24.3 (10.5, 74.6) | X (X, X) | X (X, X) |
| Baseline with vaccine scale‐up d | 157.1 (115.5, 243.8) | 29.3 (15.2, 57.1) | 14.9 (8.2, 35.4) | X (2092, X) | X (X, X) |
| Single‐visit interventions between ages 35 and 39 | |||||
| HPV DNA testing | 149.9 (110.3, 229.6) | 23.5 (12.4, 45.8) | 12.8 (7.0, 30.3) | X (2079, X) | X (X, X) |
| HPV DNA genotyping | 151.2 (111.3, 232.1) | 26.8 (14.3, 52.7) | 15.3 (8.4, 36.7) | X (2094, X) | X (X, X) |
| AVE | 150.4 (110.6, 229.4) | 24.5 (12.5, 46.1) | 13.2 (7.2, 30.6) | X (2080, X) | X (X, X) |
| HPV DNA with AVE triage | 151.2 (111.2, 231.1) | 25.0 (12.8, 47.4) | 13.4 (7.3, 31.2) | X (2081, X) | X (X, X) |
| Single‐visit interventions at ages 35–39 and 45–59 | |||||
| HPV DNA testing | 131.9 (97.1, 197.3) | 18.3 (10.0, 36.3) | 10.4 (5.9, 25.7) | X (2070, X) | X (X, X) |
| HPV DNA genotyping | 135.8 (100.2, 205.1) | 23.9 (13.3, 48.2) | 15.2 (8.4, 36.6) | X (2093, X) | X (X, X) |
| AVE | 132.2 (96.7, 195.9) | 19.3 (10.0, 36.6) | 10.8 (6.2, 26.1) | X (2071, X) | X (X, X) |
| HPV DNA with AVE triage | 134.3 (98.6, 200.6) | 20.6 (10.5, 38.5) | 11.3 (6.4, 27.0) | X (2072, X) | X (X, X) |
| Single‐visit interventions with HIV‐targeted screening e | |||||
| HPV DNA testing | 108.3 (79.0, 156.1) | 11.0 (6.2, 22.5) | 7.3 (3.7, 18.0) | 2076 (2057, X) | X (2114, X) |
| HPV DNA genotyping | 115.3 (85.2, 170.3) | 20.6 (11.9, 42.5) | 15.1 (8.3, 36.6) | X (2091, X) | X (X, X) |
| AVE | 109.1 (79.5, 156.7) | 12.2 (6.7, 24.0) | 8.2 (4.2, 19.2) | 2077 (2058, X) | X (X, X) |
| HPV DNA with AVE triage | 113.7 (82.6, 162.7) | 12.9 (7.1, 25.9) | 8.5 (4.7, 20.3) | 2081 (2060, X) | X (X, X) |
Abbreviations: AVE, automated visual evaluation; HPV, human papillomavirus; LLETZ, large loop excision of the transformation zone.
a
Standardized to the 2015 World Population.
b
Median and range of estimates from simulations using the 25 best‐fitting parameter sets.
c
X denotes that the elimination threshold was not reached in the simulated time horizon.
d
Non‐avalent hrHPV vaccination of girls aged 9–14 scaled up from 57% to 90% coverage. Vaccination coverage remains at 90% for all single‐visit scenarios.
e
Ages 35–39 and 45–49 for women living without HIV and every 5 years from 25 to 49 for women living with HIV.