Models of cervical screening in the era of human papillomavirus vaccination
Karen CanfellCancer Epidemiology Research Unit, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, NSW 2010, Australia; School of Public Health, University of Sydney, Sydney, NSW 2006, Australia. Email: karenc@nswcc.org.au
Sexual Health 7(3) 359-367 https://doi.org/10.1071/SH10016
Submitted: 15 February 2010 Accepted: 28 May 2010 Published: 19 August 2010
Abstract
Epidemiologic and economic evaluation using simulation modelling can support complex policy decisions, and is an important tool in predicting the future interaction between human papillomavirus vaccination and cervical screening. Several categories of screening program evaluation are of interest, including: (1) changes to screening considered over the short term, over which the effects of vaccination should be confined to the youngest age groups (<30 years old); (2) the medium and long-term effect of vaccination on the screening program; and (3) changes to screening in context of vaccination. This review considers some of the policy questions in each category and discusses the modelling implications, with particular focus on the Australian context.
Additional keywords: Australia, Pap smear, simulation modelling.
Acknowledgements
I wish to thank the members of the research group Modellers Sans Frontières and collaborators, whose work is referenced here. These include Mark Clements, Jie-Bin Lew, Megan Smith, Carolyn Nickson, Robert Walker, Prudence Creighton, Rosa Legood, Kirsten Howard, Sally Lord, Suzanne Dyer, Yoon Jung Kang, Leonardo Simonella and Ruanne Barnabas. I would also like to thank the Advisory Panel for MSAC evaluations #1122/Reference #39, and Dr Jeffrey Tan for expert review and input into the model of cervical screening discussed here. My research group receives funding from a variety of non-commercial sources including the NHMRC (project grant #440200); screening program or government sources in Australia, New Zealand and the UK; Cancer Council NSW; and the UICC.
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