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We evaluated the impact and cost\u2010effectiveness of switching an entire organized screening program to primary HPV self\u2010sampling among cohorts of HPV vaccinated and unvaccinated Norwegian women. We conducted a model\u2010based analysis to project long\u2010term health and economic outcomes for birth cohorts with different HPV vaccine exposure, that is, preadolescent vaccination (2000\u2010 and 2008\u2010cohorts), multiage cohort vaccination (1991\u2010cohort) or no vaccination (1985\u2010cohort). We compared the cost\u2010effectiveness of switching current guidelines with clinician\u2010collected HPV testing to HPV self\u2010sampling for these cohorts and considered an additional 44 strategies involving either HPV self\u2010sampling or clinician\u2010collected HPV testing at different screening frequencies for the 2000\u2010 and 2008\u2010cohorts. Given Norwegian benchmarks for cost\u2010effectiveness, we considered a strategy with an additional cost per quality\u2010adjusted life\u2010year below $55\u2009000 as cost\u2010effective. HPV self\u2010sampling strategies considerably reduced screening costs (ie, by 24%\u201040% across cohorts and alternative strategies) and were more cost\u2010effective than clinician\u2010collected HPV testing. For cohorts offered preadolescent vaccination, cost\u2010effective strategies involved HPV self\u2010sampling three times (2000\u2010cohort) and twice (2008\u2010cohort) per lifetime. In conclusion, we found that switching from clinician\u2010collected to self\u2010collected HPV testing in cervical screening may be cost\u2010effective among both highly vaccinated and unvaccinated cohorts of Norwegian women.<\/jats:p>","DOI":"10.1002\/ijc.33850","type":"journal-article","created":{"date-parts":[[2021,10,20]],"date-time":"2021-10-20T20:27:02Z","timestamp":1634761622000},"page":"491-501","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Switching clinic\u2010based cervical cancer screening programs to human papillomavirus self\u2010sampling: A cost\u2010effectiveness analysis of vaccinated and unvaccinated Norwegian women"],"prefix":"10.1002","volume":"150","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4923-0670","authenticated-orcid":false,"given":"Kine","family":"Pedersen","sequence":"first","affiliation":[{"name":"Department of Health Management and Health Economics University of Oslo  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8467-1324","authenticated-orcid":false,"given":"Allison","family":"Portnoy","sequence":"additional","affiliation":[{"name":"Center for Health Decision Science Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen","family":"Sy","sequence":"additional","affiliation":[{"name":"Center for Health Decision Science Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2765-4488","authenticated-orcid":false,"given":"Bo T.","family":"Hansen","sequence":"additional","affiliation":[{"name":"Cancer Registry of Norway  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameli","family":"Trop\u00e9","sequence":"additional","affiliation":[{"name":"Cancer Registry of Norway  Oslo Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane J.","family":"Kim","sequence":"additional","affiliation":[{"name":"Center for Health Decision Science Harvard T.H. Chan School of Public Health  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6657-5849","authenticated-orcid":false,"given":"Emily A.","family":"Burger","sequence":"additional","affiliation":[{"name":"Department of Health Management and Health Economics University of Oslo  Oslo Norway"},{"name":"Center for Health Decision Science Harvard T.H. 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