Persistent infection with high-risk human papillomavirus (HR-HPV) has been linked to precancerous lesions (cervical intraepithelial neoplasia (CIN)) which may progress to cervical cancer. Guidance was issued in 2020 in France to include the use of assays to detect HR-HPV infections in a national cervical screening programme.
A decision tree model was developed to evaluate the impact of using a similarly sensitive, but more specific, mRNA HR-HPV assay (Aptima HR-HPV assay) compared to a DNA HR-HPV test (cobas 4800 HPV assay) in the proposed cervical screening algorithm in France. Results showed using an mRNA assay could yield an estimated annual cost saving of €6.5 million and reduce the total number of colposcopies, HPV and cytology tests required. As mRNA and DNA assays have similar test sensitivity, true positives will not be missed, and total costs are reduced by eliminating unnecessary colposcopy referrals, HR-HPV and cytology tests.
Dombrowski C, Weston G, Descamps P, Izopet J, Adams E. Evaluating the choice of HPV assay in the French cervical screening programme with a decision tree model. Poster presented at: EUROGIN International Multidisciplinary HPV Congress; 2021 May 30 – June 1; Virtual.