{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,28]],"date-time":"2026-03-28T22:00:49Z","timestamp":1774735249786,"version":"3.50.1"},"reference-count":56,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2013,4,22]],"date-time":"2013-04-22T00:00:00Z","timestamp":1366588800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Obstet Gynecol Scand"],"published-print":{"date-parts":[[2013,7]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Human papillomavirus (<jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content>) testing is not currently used in primary cervical cancer screening in Sweden, and corresponding cost\u2010effectiveness is unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>From a societal perspective, to evaluate the cost\u2010effectiveness of high\u2010risk (<jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>)\u2010<jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> testing using self\u2010collected vaginal samples.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cost\u2010effectiveness analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>The Swedish organized cervical cancer screening program.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We constructed a model to simulate the natural history of cervical cancer using Swedish data on cervical cancer risk. For the base\u2010case analysis we evaluated two screening strategies with different screening intervals: (i) cytology screening throughout the woman's lifetime (i.e. \u201cconventional cytology strategy\u201d) and (ii) conventional cytology screening until age 35\u00a0years, followed by <jats:styled-content style=\"fixed-case\">HR<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">HPV<\/jats:styled-content> testing using self\u2010collected vaginal samples in women aged \u226535\u00a0years (i.e. \u201ccombination strategy\u201d). Sensitivity analyses were performed, varying model parameters over a significant range of values to identify cost\u2010effective screening strategies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Main outcome measures<\/jats:title><jats:p>Average lifetime cost, discounted and undiscounted life\u2010years gained, reduction in cervical cancer risk, incremental cost\u2010effectiveness ratios with and without the cost of added life\u2010years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Depending on screening interval, the incremental cost\u2010effectiveness ratios for the combination strategy ranged from \u20ac43\u00a0000 to \u20ac180\u00a0000 per life\u2010years gained without the cost of added life\u2010years, and from \u20ac74\u00a0000 to \u20ac206\u00a0000 with costs of added life\u2010years included.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination strategy with a 5\u2010year screening interval is potentially cost\u2010effective compared with no screening, and with current screening practice when using a threshold value of \u20ac80\u00a0000 per life\u2010years gained.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aogs.12143","type":"journal-article","created":{"date-parts":[[2013,3,27]],"date-time":"2013-03-27T09:57:18Z","timestamp":1364378238000},"page":"830-840","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":22,"title":["Projected cost\u2010effectiveness of repeat high\u2010risk human papillomavirus testing using self\u2010collected vaginal samples in the Swedish cervical cancer screening program"],"prefix":"10.1111","volume":"92","author":[{"given":"Ellinor","family":"\u00d6stensson","sequence":"first","affiliation":[{"name":"Department of Women's and Children's Health Division of Obstetrics and Gynecology Karolinska University Hospital\u2010Solna Karolinska Institute Stockholm 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