The task force commissioned Dr. Kim’s team to analyze various screening scenarios using mathematical modeling. This type of model integrates information on how cervical cancers typically progress and the impact of interventions, based on empirical evidence from clinical trials and observational studies. The team looked at 19 different screening options, such as Pap testing alone, HPV testing alone, and co-testing, and considered different starting ages and different screening intervals. They also considered which options would provide the biggest health benefit to women – such as fewer cervical cancer-related deaths – as well as which would cause the most harm, such as additional and perhaps unnecessary invasive testing.
Compared to the 2012 recommendations, they found that there were strategies that could lead to near equivalent or even better health benefits for women with HPV testing alone. One scenario that gives similar benefits at a lower rate of harm is initiating Pap testing every three years starting at age 21 years and switching to HPV testing alone every five years at age 30 years. Under this scenario, they estimated a cervical cancer-related death rate of 0.29 per 1,000 women over the course of a lifetime of screenings.
“The bottom line is that all of these various screening strategies provide a huge benefit”, Jane shared, adding, “without doing any screening, the rate of cervical cancer deaths would be over 8 per 1,000 women over a lifetime of screening—much higher than any of the screening strategies we looked at. We are lucky to have these amazing screening technologies and great ways to use them. The question is how to use them in the most accessible, efficient, and cost-effective way.”
Learn more: Read the full Harvard Chan School interview with Jane Kim.
Learn more: Read the full cervical cancer guidelines.
Learn more: Read about practice and policy at CHDS.