{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T11:15:56Z","timestamp":1777634156387,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T00:00:00Z","timestamp":1769558400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","award":["847845"],"award-info":[{"award-number":["847845"]}],"id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl Journal of Cancer"],"published-print":{"date-parts":[[2026,6,15]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>In 2017, the Netherlands introduced primary human papillomavirus (HPV)\u2010based screening with cytology triage, which increased colposcopy referrals and low\u2010grade lesions detected. In 2022, HPV16\/18 genotyping was added for women with borderline\/low\u2010grade cytology. Triage with HPV genotyping may better balance screening benefits, harms, and costs. Therefore, we evaluated the cost\u2010effectiveness of 19 triage strategies based on net monetary benefit (NMB) at cost\u2010effectiveness thresholds of \u20ac20,000 and \u20ac50,000\/quality\u2010adjusted life\u2010year (QALY), with the highest NMB indicating the most cost\u2010effective strategy. Triage tests included 16\/18 genotyping, 7\u2010type (16\/18\/31\/33\/45\/52\/58) genotyping, and cytology (high\u2010grade squamous intraepithelial lesions [HSIL]: moderate\/severe, atypical squamous cells of undetermined significance [ASC\u2010US]\/low\u2010grade squamous intraepithelial lesions [LSIL]: borderline\/low\u2010grade, negative for intraepithelial lesion or malignancy [NILM]: normal). Effects on cancer incidence and mortality were obtained by combining POBASCAM trial data with nationwide screening and cancer registries. Time since the onset of high\u2010grade lesion (cervical intraepithelial neoplasia [grade 2\/3] [CIN2\/3]) at baseline of the Population\u2010based Screening Study Amsterdam trial cannot be estimated from the data and was varied between 0 and 10\u2009years. At a \u20ac20,000\/QALY threshold, immediate referral for HSIL and 16\/18\u2010positive ASC\u2010US\/LSIL, and repeat cytology for 16\/18\u2010negative ASC\u2010US\/LSIL and 7\u2010types positive NILM had the highest NMB (\u20ac214.1 to \u20ac309.3\/woman gained compared to referring all HPV\u2010positive women). At a \u20ac50,000\/QALY threshold, immediate referral for all 16\/18\u2010positives and\/or HSIL, and repeat cytology for 16\/18\u2010negative ASC\u2010US\/LSIL and 7\u2010types positive NILM had the highest NMB if time since onset of CIN2\/3 was greater than 2\u2009years. Cytology combined with HPV16\/18 and extended genotyping is cost\u2010effective for triage of HPV\u2010positives. Immediate colposcopy referral of all HPV16\/18\u2010positives is cost\u2010effective at a \u20ac50,000\/QALY threshold.<\/jats:p>","DOI":"10.1002\/ijc.70344","type":"journal-article","created":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T06:30:48Z","timestamp":1769668248000},"page":"3141-3151","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cost\u2010effectiveness analysis of human papillomavirus (\n                    <scp>HPV<\/scp>\n                    ) genotyping strategies for management of\n                    <scp>HPV<\/scp>\n                    \u2010positive women in cervical cancer screening"],"prefix":"10.1002","volume":"158","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-7546-4410","authenticated-orcid":false,"given":"Kelsi R.","family":"Kroon","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Data Science Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Methodology Amsterdam Public Health Research Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3389-5141","authenticated-orcid":false,"given":"Johannes A.","family":"Bogaards","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Methodology Amsterdam Public Health Research Institute  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2094-2380","authenticated-orcid":false,"given":"Johannes","family":"Berkhof","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Data Science Amsterdam UMC, location Vrije Universiteit Amsterdam  Amsterdam The Netherlands"},{"name":"Methodology Amsterdam Public Health Research Institute  Amsterdam The Netherlands"},{"name":"Imaging and Biomarkers Cancer Center Amsterdam  Amsterdam The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,1,28]]},"reference":[{"key":"e_1_2_13_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1096\u20109896(199909)189:1<12::AID\u2010PATH431>3.0.CO;2\u2010F"},{"key":"e_1_2_13_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.30579"},{"key":"e_1_2_13_4_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010019\u20101460\u20100"},{"key":"e_1_2_13_5_1","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjc.6600688"},{"key":"e_1_2_13_6_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01120\u201019"},{"key":"e_1_2_13_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12985\u2010019\u20101216\u20107"},{"key":"e_1_2_13_8_1","doi-asserted-by":"publisher","DOI":"10.1128\/Jcm.00508\u201016"},{"key":"e_1_2_13_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2025.101327"},{"key":"e_1_2_13_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(18)30763\u20100"},{"key":"e_1_2_13_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2021.100235"},{"key":"e_1_2_13_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1470\u20102045(10)70230\u20108"},{"key":"e_1_2_13_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2020.12.038"},{"key":"e_1_2_13_14_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055\u20109965.EPI\u201024\u20100046"},{"key":"e_1_2_13_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/LGT.0000000000000525"},{"key":"e_1_2_13_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.34804"},{"key":"e_1_2_13_17_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0000000000001327"},{"key":"e_1_2_13_18_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.20076"},{"key":"e_1_2_13_19_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwt077"},{"key":"e_1_2_13_20_1","unstructured":"IKNL.Cervical cancer.https:\/\/nkr-cijfers.iknl.nl\/[Accessed April 2025]"},{"key":"e_1_2_13_21_1","doi-asserted-by":"crossref","unstructured":"deCarvalhoTM BerkhofJ BogaardsJA.Cost\u2010effectiveness of risk\u2010stratified screening for cervical cancer in cohorts vaccinated against human papillomavirus with moderate vaccination coverage. 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