Nearly all cases of cervical cancer are caused by 14 high-risk human papillomavirus (HR-HPV) genotypes. Denmark and Sweden are assessing the structure of their cervical cancer screening programmes and implementing HR-HPV screening in certain populations. While both DNA and mRNA assays have similar sensitivity, mRNA assays have been shown to have higher specificity resulting in fewer false-positive results.
We adapted a decision tree model from a previously published study in England to explore how the type of assay used to detect HR HPV infections in a screening programme may impact costs, patient follow-up, and resource use. The results showed the use of mRNA tests in cervical screening for women in Sweden or Denmark instead of DNA testing would result in cost savings and a decrease in the number of unnecessary cytology tests, unnecessary recall HR-HPV tests and unnecessary colposcopies compared to HR-HPV DNA testing and can be used to inform the implementation of screening programmes with benefits for health services and women.
Dombrowski C, Weston G, Adams E. Modelling the impact of using a DNA compared to mRNA HPV assay as part of the cervical screening programmes in Sweden and Denmark. Poster presented at: EUROGIN International Multidisciplinary HPV Congress; 2021 May 30 – June 1; Virtual