Persistent infection with high-risk human papillomavirus (HR-HPV) has been linked to precancerous lesions 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 simulating the French cervical screening algorithms was developed to evaluate the effect 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 for a hypothetical cohort of women aged 25 to 65 years in France.
Results showed using an mRNA assay could yield an estimated annual cost saving of €6.5 million and reduces the total number of colposcopies, HPV and cytology tests. 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.
The choice of high-risk human papillomavirus assay makes a significant difference in resource use and costs and is important to consider when implementing cervical screening in France. Using an mRNA versus DNA assay can result in cost savings and reductions in unnecessary testing and procedures, which in turn benefits women and the health care system.
The results of this work are published in Medicine and the full text can be accessed here.
Dombrowski CA, Weston GM, Descamps PP, et al. Health economic evaluation of an mRNA high-risk human papillomavirus (HR-HPV) assay versus a DNA HR-HPV assay for the proposed French cervical screening programme. Medicine (Baltimore). 2022 Jul 22;101(29):e29530.
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