{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T23:43:04Z","timestamp":1777160584947,"version":"3.51.4"},"reference-count":26,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T00:00:00Z","timestamp":1678320000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Women's Health"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Cervical cancer is a major concern to women\u2019s health, being the fourth most common cancer worldwide. A great percentage of these cancer is consequence of an HPV infection, namely from specific genotypes such as 16\/18. Portuguese screening program subjects women to a reflex cytology triage every 5 years. Aptima\u00ae HPV is a screening test which presents better specificity than other tests which are used in Portugal (Hybrid Capture\u00ae 2 and Cobas\u00ae 4800) and still have a comparable sensitivity. The present study aims to estimate the number of diagnostic tests and costs that are avoided using Aptima\u00ae HPV compared to the use of two other tests, Hybrid Capture\u00ae 2 and Cobas\u00ae 4800, within the cervical cancer screening programme in Portugal.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A model, consisting of a decision-tree, was developed to represent the full Portuguese screening program for cervical cancer. This model is used to compare the costs resulting from using Aptima\u00ae HPV test versus the other tests used in Portugal, during 2\u00a0years. Other outcomes such as the number of additional tests and exams were also computed. This comparison considers the performance of each test (sensitivity and specificity) and assumes an equal price for every test compared.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Cost savings resulting from the use of Aptima\u00ae HPV are estimated at approximately \u20ac382 million versus Hybrid Capture\u00ae 2 and \u20ac2.8 million versus Cobas\u00ae 4800. Moreover, Aptima\u00ae HPV prevents 265,443 and 269,856 additional tests and exams when compared with Hybrid Capture\u00ae 2 and Cobas\u00ae 4800.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>The use of Aptima\u00ae HPV resulted in lower costs as well as less additional test and exams. These values result from the greater specificity of Aptima\u00ae HPV, which signals less false positive cases and consequently avoids carrying out additional tests.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12905-023-02219-0","type":"journal-article","created":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T08:03:56Z","timestamp":1678349036000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Performance of Aptima-HPV in the cervical cancer screening program of Portugal: a cost-analysis"],"prefix":"10.1186","volume":"23","author":[{"given":"Daniel","family":"Figueiredo","sequence":"first","affiliation":[]},{"given":"In\u00eas","family":"Ribeiro","sequence":"additional","affiliation":[]},{"given":"Ana","family":"Penedones","sequence":"additional","affiliation":[]},{"given":"Diogo","family":"Mendes","sequence":"additional","affiliation":[]},{"given":"Carlos","family":"Alves","sequence":"additional","affiliation":[]},{"given":"Francisco","family":"Batel-Marques","sequence":"additional","affiliation":[]},{"given":"Daniel Pereira","family":"da Silva","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,3,9]]},"reference":[{"key":"2219_CR1","unstructured":"Global Cancer Observatory. Estimated age-standardized incidence and mortality rates (World) in 2020, both sexes, all ages (excl. NMSC) (https:\/\/gco.iarc.fr\/today\/online-analysis-dual-bars-2?v=2020, last accessed by December 6, 2022)."},{"key":"2219_CR2","unstructured":"Sociedade Portuguesa de Ginecologia. Consenso Sobre Infec\u00e7\u00e3o Por HPV E Neoplasia Intraepitelial Do Colo Vulva E Vagina.; 2014."},{"key":"2219_CR3","doi-asserted-by":"publisher","DOI":"10.3390\/v10120729","author":"AC Chrysostomou","year":"2018","unstructured":"Chrysostomou AC, Stylianou DC, Constantinidou A, Kostrikis LG. Cervical cancer screening programs in Europe: the transition towards HPV vaccination and population-based HPV testing. Viruses. 2018. https:\/\/doi.org\/10.3390\/v10120729.","journal-title":"Viruses"},{"issue":"9916","key":"2219_CR4","doi-asserted-by":"publisher","first-page":"524","DOI":"10.1016\/S0140-6736(13)62218-7","volume":"383","author":"G Ronco","year":"2014","unstructured":"Ronco G, Dillner J, Elfstr\u00f6m KM, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383(9916):524\u201332. https:\/\/doi.org\/10.1016\/S0140-6736(13)62218-7.","journal-title":"Lancet"},{"issue":"1","key":"2219_CR5","doi-asserted-by":"publisher","first-page":"235","DOI":"10.1186\/s12889-019-6536-4","volume":"19","author":"A Pista","year":"2019","unstructured":"Pista A, Costa C, Saldanha C, et al. Budget impact analysis of cervical cancer screening in Portugal: comparison of cytology and primary HPV screening strategies. BMC Public Health. 2019;19(1):235. https:\/\/doi.org\/10.1186\/s12889-019-6536-4.","journal-title":"BMC Public Health"},{"key":"2219_CR6","unstructured":"Hologic. General Information Aptima TM General Information.; 2017."},{"key":"2219_CR7","unstructured":"Hologic. Aptima HPV 16 18\/45 Genotype Assay.; 2017."},{"issue":"4","key":"2219_CR8","doi-asserted-by":"publisher","first-page":"333","DOI":"10.1097\/LGT.0000000000000143","volume":"19","author":"J Ting","year":"2015","unstructured":"Ting J, Smith JS, Myers ER. Cost-effectiveness of high-risk human papillomavirus testing with messenger RNA versus DNA under United States guidelines for cervical cancer screening. J Low Genit Tract Dis. 2015;19(4):333\u20139. https:\/\/doi.org\/10.1097\/LGT.0000000000000143.","journal-title":"J Low Genit Tract Dis"},{"issue":"2","key":"2219_CR9","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1128\/JCM.02147-10","volume":"49","author":"S Ratnam","year":"2011","unstructured":"Ratnam S, Coutlee F, Fontaine D, et al. Aptima HPV E6\/E7 mRNA test is as sensitive as hybrid capture 2 assay but more specific at detecting cervical precancer and cancer. J Clin Microbiol. 2011;49(2):557\u201364. https:\/\/doi.org\/10.1128\/JCM.02147-10.","journal-title":"J Clin Microbiol"},{"key":"2219_CR10","doi-asserted-by":"publisher","first-page":"S40","DOI":"10.1016\/j.jcv.2015.10.027","volume":"76","author":"J Haedicke","year":"2016","unstructured":"Haedicke J, Iftner T. A review of the clinical performance of the Aptima HPV assay. J Clin Virol. 2016;76:S40\u20138. https:\/\/doi.org\/10.1016\/j.jcv.2015.10.027.","journal-title":"J Clin Virol"},{"key":"2219_CR11","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/J.JCV.2018.09.004","volume":"108","author":"DA Cook","year":"2018","unstructured":"Cook DA, Smith LW, Law JH, et al. Comparative performance of human papillomavirus messenger RNA versus DNA screening tests at baseline and 48 months in the HPV FOCAL trial. J Clin Virol. 2018;108:32\u20137. https:\/\/doi.org\/10.1016\/J.JCV.2018.09.004.","journal-title":"J Clin Virol"},{"key":"2219_CR12","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01177-18","author":"H TIftner","year":"2019","unstructured":"TIftner H, Neis KJ, Castanon A, et al. Longitudinal clinical performance of the RNA-based Aptima human papillomavirus (AHPV) assay in comparison to the DNA-based hybrid capture 2 HPV test in two consecutive screening rounds with a 6-year interval in Germany. J Clin Microbiol. 2019. https:\/\/doi.org\/10.1128\/JCM.01177-18.","journal-title":"J Clin Microbiol."},{"issue":"5","key":"2219_CR13","doi-asserted-by":"publisher","first-page":"511.e1","DOI":"10.1016\/J.AJOG.2021.05.038","volume":"225","author":"THR Strang","year":"2021","unstructured":"Strang THR, Gottschlich A, Cook DA, et al. Long-term cervical precancer outcomes after a negative DNA- or RNA-based human papillomavirus test result. Am J Obstet Gynecol. 2021;225(5):511.e1-511.e7. https:\/\/doi.org\/10.1016\/J.AJOG.2021.05.038.","journal-title":"Am J Obstet Gynecol"},{"key":"2219_CR14","unstructured":"Arbyn M, Anttila A, Jordan J, et al. European Guidelines for Quality Assurance in Cervical Cancer Screening Second Edition."},{"key":"2219_CR15","unstructured":"Perelman J, Soares M, Mateus C, Duarte A, Faria R, Ferreira L, Saramago P, Veiga P, Furtado C, Caldeira S, Teixeira MC SM. 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BMJ Open. 2020;10(3):1\u201310. https:\/\/doi.org\/10.1136\/bmjopen-2019-031303.","journal-title":"BMJ Open"},{"issue":"1","key":"2219_CR26","doi-asserted-by":"publisher","first-page":"178","DOI":"10.1186\/s12905-021-01310-8","volume":"21","author":"R Ib\u00e1\u00f1ez","year":"2021","unstructured":"Ib\u00e1\u00f1ez R, Mareque M, Granados R, et al. Comparative cost analysis of cervical cancer screening programme based on molecular detection of HPV in Spain. BMC Womens Health. 2021;21(1):178. https:\/\/doi.org\/10.1186\/s12905-021-01310-8.","journal-title":"BMC Womens Health"}],"updated-by":[{"DOI":"10.1186\/s12905-024-02927-1","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2024,2,8]],"date-time":"2024-02-08T00:00:00Z","timestamp":1707350400000}}],"container-title":["BMC Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-023-02219-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12905-023-02219-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12905-023-02219-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,3,9]],"date-time":"2023-03-09T08:04:08Z","timestamp":1678349048000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcwomenshealth.biomedcentral.com\/articles\/10.1186\/s12905-023-02219-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,9]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["2219"],"URL":"https:\/\/doi.org\/10.1186\/s12905-023-02219-0","relation":{"correction":[{"id-type":"doi","id":"10.1186\/s12905-024-02927-1","asserted-by":"object"}]},"ISSN":["1472-6874"],"issn-type":[{"value":"1472-6874","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,9]]},"assertion":[{"value":"16 May 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"9 March 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The objective of this study was to estimate the number of diagnostics tests and costs that are avoided using Aptima HPV compared to other two methodologies within the cervical cancer screening programme in Portugal. The study followed the Portuguese Methodological Guidelines for Economic Evaluation Studies of Health Technologies. To obtain data on the procedures used to follow-up women after their first HPV test in Portugal, a literature search was performed. However, due to the absence of such information, an expert panel was reunited. This expert panel was constituted by clinicians of the medical specialties of gynaecology, anatomical pathology and public health. Although this method was not preferential, it has been successful used in the development of pharmacoeconomic studies and it is recognized by the Portuguese Methodological Guidelines for Economic Evaluation Studies of Health Technologies. No patients were included in this study. Therefore, no ethical committee approval was necessary. All experts who incorporate this panel are thus consultants and they were informed about the context and goal of the study. They were included in the panel only after their consent to participate. This consent is obtained in a written form.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"96"}}