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Table 1 Summary of findings and recommendations

From: Systematic review of model-based cervical screening evaluations

Type of intervention
- Screening should be introduced (34/34, 100%)
- Cytology-based screening should have screening intervals ≥3 years (18/23, 78%), starting age ≥25 years old (9/10, 90%), and stopping age ≥60 years old (5/5, 100%)
  - No post-hysterectomy screening follow-up should be given to women >40 years old (1/1, 100%)
Technologies assessed
- Liquid-based cytology is recommended over conventional cytology (18/27, 67%)
- Automated reading should be introduced (6/7, 86%)
- HPV DNA testing for primary screening is more cost-effective than cytology (15/17, 88%)
- Co-testing is more cost-effective than cytology in HIC (6/7, 86%)
- HPV DNA testing is supported over co-testing and cytology alone (10/17, 59%)
- HPV DNA to triage minor cytological abnormalities is endorsed over (i)repeat cytology and immediate colposcopy (7/8), (ii)immediate treatment (1/1), or (iii)co-testing (1/1) (9/10, 90%)
- HPV DNA testing for post-treatment screening should be introduced (2/3, 67%)
- Rapid HPV DNA testing should be introduced in China (3/3, 100%)
- Self-sampled HPV DNA testing as primary screening in HIC is cost-effective versus clinic-based HPV DNA or conventional cytology alone(2/2, 100%); however, in upper-middle income countries, it is not cost-effective versus other technologies, such as clinic-based HPV DNA (2/2, 100%)
- HPV 16/18 genotyping should be introduced for triage of equivocal results of co-testing versus co-testing alone, HPV DNA with LBC triage, LBC with HPV DNA triage, or LBC alone (1/1, 100%)
- HPV DNA is more cost-effective than VIA in LMIC (1/1; 100%)
- VIA is more cost-effective than cytology in LMIC (2/2; 100%)
Screening and Vaccination
- Screening should be introduced even in a post-vaccination setting (10/12, 83%)
- Screening should be continued after vaccination is introduced (10/12, 83%)
- Post-vaccination HPV DNA primary screening is cost-effective compared to cytology alone in HIC (5/5, 100%)
  1. Figures in parentheses show the proportion (x/y) and percentage (%) of relevant studies supporting each recommendation.