While cervical cancer cases in Canada have decreased recently due to cytology primary screening, cervical cancer remains a relatively common and preventable cause of cancer in women. Cervical cancer is primarily caused by persistent genital infection with high-risk human papillomaviruses (HR-HPV). Ontario Health has been evaluating implementing HPV-based testing in cervical screening.
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 assay (Hybrid Capture 2 HPV assay) in a hypothetical cervical screening algorithm in Ontario, Canada. Results indicated that screening using an mRNA assay could yield cost savings of $4M CAD and a reduction in unnecessary colposcopies, HPV, and cytology tests. These results indicate that the choice of HR-HPV test is important when implementing a primary HPV screening program to avoid unnecessary resource use and cost, which will benefit both women and healthcare providers.
Weston G, Dombrowski C, Steben M, et al.A health economic model to estimate the costs and benefits of an mRNA vs DNA high-risk HPV assay in a hypothetical HPV primary screening algorithm in Ontario, Canada. Preventive Medicine Reports [Internet]. 2021 Sep 1 [cited 2021 Jul 29];23:101448. Available from: https://www.sciencedirect.com/science/article/pii/S2211335521001388