||3U01CA253912-03S3 Interpret this number
||Harvard School Of Public Health
||Comparative Modeling to Inform Cervical Cancer Control Policies: Uspstf Supplement
When the US Preventive Services Task Force (USPSTF) last updated their cervical cancer screening
guidelines in August 2018, they added a recommendation for screening every 5 years with high-risk human
papillomavirus (hrHPV) testing alone in addition to previously recommended screening strategies for cervical
cancer for women aged 30 to 65 years, including screening every 3 years with cervical cytology alone or every
5 years with hrHPV testing in combination with cytology (cotesting). Since then, new data have emerged that
could change conclusions about the balance of benefits and harms of cervical cancer screening for average-
risk and low-risk women. In particular, new evidence has been published regarding the performance and
acceptability of hrHPV testing, especially in subgroup populations (i.e., by age and vaccination status).
Moreover, the emerging use of self-collection of vaginal samples for hrHPV testing may promote equitable
access to cervical cancer screening among certain underscreened populations.
For this administrative supplement, we propose to work with the USPSTF and their evidence practice center
(EPC) to use simulation models to synthesize this new knowledge and evaluate the harms and benefits of
alternative cervical cancer screening strategies. Specifically, we aim to use four well-established simulation
models to: (1) Estimate the lifetime outcomes across the US population of adult women under different
scenarios for cervical cancer screening - outcomes will include benefits (e.g., cervical cancer cases and deaths
averted, gains in life years), harms (false-negative results, false positive findings, number of colposcopies and
excisional treatments), and the relative efficiency of different strategies. Scenarios may vary by modality,
screening interval, age and vaccination status; (2) Explore if self-collection of hrHPV may be used to reduce
cervical cancer disparities for certain sub-group populations; and (3) Explore whether compared to the
average-risk population, there are differences in the balance of benefits, harms and efficiency of screening
strategies in key sub-groups of the population (e.g., by race, vaccination status).
These results are intended to provide evidence on the tradeoffs of harms and benefits of cervical cancer
screening to inform the USPSTF as they re-evaluate guidelines from 2018.
None. See parent grant details.