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Table 1 Model parameters for screening, diagnosis, treatment and utilities; and ranges for sensitivity analysis

From: Evaluation of primary HPV-DNA testing in relation to visual inspection methods for cervical cancer screening in rural China: an epidemiologic and cost-effectiveness modelling study

Parameter

Baseline value

Range for sensitivity analysis

Screening and test characteristics

  

Screening participation rate for once-lifetime screening (%)†

71

40 - 100

Proportion of women never screened in lifetime in program-based screening (%)††

15

 

Total participation rate over one screening round for program-based screening (age-standardised to local population for 30-59 years) (%)†

62

35 - 100

Rate of technically inadequate tests for careHPV (%)††

0

0 - 10

Rate of loss to follow-up after screening, diagnosis or treatment (if follow-up not performed the same day) (%)††

10

5 - 20

Age-specific rate of unsatisfactory visual tests if performed as first visual test in management process (VIA, VIA/VILI or colposcopy) (%)‡

  

20-34 years

5

0 - 5

35-39 years

6

0 - 6

40-44 years

7

0 - 7

45-49 years

16

0 - 16

50-54 years

35

0 - 35

55+ years

59

0 - 59

Conditional probability of an unsatisfactory colposcopy, given a prior unsatisfactory visual test (%)‡

92

80 - 100

LEEP treatment success rate (%) [12]

93.6

90 - 100

Age-standardised annual progression rate from CIN3 to cancer (%) [11]

1.4

0.7 - 2.8

Proportion of CIN3 treated by hysterectomy in rural Chinese settings (%)

21.1

5 - 21.1

5-year survival by FIGO stage (%) [13]

(+/-10% of baseline values)

  

FIGO I

88.0

79.1 - 96.7

FIGO II

68.0

61.2 - 74.8

FIGO III

41.3

37.2 - 45.5

FIGO IV

15.5

13.9 - 17.0

Sexual behaviour parameters

  

Per-partnership HPV transmission probability [9]

0.6

-

Age group and sexual behaviour group mixing probability††

  

Same five-year age group mixing

0.7

-

Random age group mixing

0.3

-

Same sexual activity group mixing (four activity groups)

0.7

-

Random sexual activity group mixing

0.3

-

Average age-specific new annual partnerships (across sexual activity groups) in females/ males‡‡

  

10-14 years

0.000/ 0.000

-

15-19 years

0.097/ 0.094

-

20-24 years

0.316/ 0.263

-

25-29 years

0.029/ 0.029

-

30-34 years

0.008/ 0.008

-

35-39 years

0.045/ 0.053

-

40-44 years

0.039/ 0.047

-

45-50 years

0.075/ 0.075

-

50-54 years

0.021/ 0.021

-

55+ years

0.011/ 0.011

-

Aggregated costs (in US$)*

  

VIA ($) - once or twice-lifetime (mobile) screening at district hospital

3.55

2.84 - 4.26

VIA ($) - program-based screening at county hospital

4.30

3.44 - 5.16

VILI ($) - district or county hospital

0.40

0.32 - 0.48

careHPV total cost - self-sampling ($)

(including labour cost, assuming test cost = US$5)

9.20

7.20 - 14.20

careHPV total cost - provider-sampling ($)

(including labour cost, assuming test cost = US$5)

10.34

8.34 - 15.34

LEEP ($)

55.95

44.76 - 67.13

Cancer treatment cost ($):

  

FIGO I

627.64

502.11 - 753.16

FIGO II

1953.20

1562.56 - 2343.83

FIGO III

1810.17

1448.13 - 2172.20

FIGO IV

662.61

530.09 - 795.1

Discount rate (%) [24]

3.6

0 - 5

Secondary analysis of utilities (reference = 1.0 for perfect health) [19–21]

  

Having a screening test

0.999945

0.999616 - 0.999956

Screening test positive with no treatment on the same day

0.999918

0.998849 - 0.999934

Colposcopy negative

0.999877

0.998274 - 0.999901

Colposcopy positive and biopsy negative

0.9965

0.992603 - 0.997238

Colposcopy positive then biopsy confirmed CIN1 with no treatment

0.9965

0.992603 - 0.997238

Colposcopy positive then biopsy confirmed CIN1 with LEEP treatment

0.984

0.935178 - 0.987178

Colposcopy positive then biopsy confirmed CIN2-3 with LEEP treatment

0.984

0.935178 - 0.987178

Colposcopy positive then biopsy confirmed CIN3 with hysterectomy treatment

0.85

0.82 - 0.88

Cancer - FIGO I

0.76

0.65 - 0.76

Cancer - FIGO II

0.67

0.56 - 0.67

Cancer - FIGO III

0.67

0.56 - 0.67

Cancer - FIGO IV

0.67

0.48 - 0.67

  1. † Data source: Professor You-Lin Qiao, personal communication (based on a demonstration screening project in Xiangyuan County, Shanxi Province 2006);
  2. †† Assumption (no data available);
  3. ‡ Re-analysis of data on colposcopy unsatisfactory rates from Dai et al [5];
  4. ‡‡ Female data were based on re-analysis of the IARC/CICAMS study [5], and male sexual contact data were assumed based on female data;
  5. * Micro-costing study results as described in text. Range for sensitivity analysis +/-20% of baseline values.
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BMC Cancer

ISSN: 1471-2407

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