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.