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Table 1 Markov model inputs

From: Modeling optimal cervical cancer prevention strategies in Nigeria

Variable

Input value

Data source

Vaccination

Vaccine coverage

50% to 95%

Assumption

Vaccine efficacy 16-18

98%

[35, 36]

Proportion of HPV 16/18 related CIN1, CIN2/3 and CC

22%, 41%, 50%

[37]

Vaccine efficacy 10 other HPV oncogenic types

68.3%

[36, 38]

Proportion of 10 other HPV type related CIN1, CIN2/3 and CC

24%, 35% 32%

[37]

Age at vaccination

12 years

Assumption

Vaccine waning

None

Assumption

Screening

Once—age

35 years

Assumption

Twice—ages

35, 40 years

Assumption

Three times—ages

35, 40, 45 years

Assumption

Percentage screened

20% to 40%

Assumption

Cytology sensitivity CIN1

70%

[39]

Cytology sensitivity CIN2/3

80%

[39]

Compliance with CIN1 treatment

100%

[39]

Compliance with CIN2/3 treatment

100%

[39]

Efficacy of CIN treatment

95%

[39]

Cost (2011 US dollars)*

Vaccine cost per dose

2365 NGN ($15)

PAHO price

Cytology test

3010 NGN ($16)

[40]

Colposcopy + biopsy

7225 NGN ($46)

[40]

Annual CIN1 treatment (average resources used per patient: 1.7 consultations, 3.2 procedures, 1.1 medications, 0.5 hospitalizations)

40,672 NGN ($258)

[40]

Annual CIN2/3 treatment (average resources used per patient: 1.8 consultations, 4.1 procedures, 2.1 medications, 0.9 hospitalizations)

68,200 NGN ($432)

[40]

Lifetime CC treatment cost (average resources used per patient: 2.4 consultations, 7.1 procedures, 6.1 medications, 1.1 hospitalizations)

227,026 NGN ($1440)

[40]

Transition probabilities

Age-specific mortality rate

0.01 to 1

[41]

Uninfected to HPV

0.0 to 0.14

[34]

HPV to CIN1

0.05

[42]

CIN1 to CIN 2/3

0.09

[43–45]

CIN2/3 to persistent CIN2/3

0.11

[43, 44]

HPV clearance to uninfected

0.29 to 0.55

[42, 44–46]**

CIN1 clearance

0.45

[43–45, 47, 48]

CIN 2/3 clearance

0.23

[43–45, 47, 48]

Persistent CIN2/3 to cancer

0.0 to 0.10

Estimated from calibration to CC

Cancer to cancer cured

0.084

Estimated from 5-year survival of 34.4% Nigeria ([1])

  1. CIN1 = Cervical intraepithelial neoplasia, grade 1; CIN2/3 = Cervical intraepithelial neoplasia, grades 2 and 3; HPV = Human papillomavirus; NGN = Nigerian naira.
  2. *Exchange rate used 1 NGN = $0.0063.
  3. **Age-specific HPV clearances were used as reported in the literature.
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BMC Cancer

ISSN: 1471-2407

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