Despite successful cervical cancer screening in the United States, over 12,000 women develop and 4,000 women die from cervical cancer each year. New technologies, including screening tests and vaccines against human papillomavirus (HPV), a sexually-transmitted virus known to cause cervical cancer, represent tremendous opportunities for innovative and efficient cervical cancer programs in the U.S. but also pose significant challenges for decision making, due to the complex and long natural history of disease and the different time points along the disease spectrum at which interventions are applied. Consequently, policy makers are uniquely reliant on mathematical modeling to provide evidence on the optimal cervical cancer control strategies. These models can be used to integrate the most up-to-date data, extrapolate current short- term findings into long-term outcomes, and evaluate what-if scenarios that would otherwise be impractical or infeasible to conduct in clinical studies. There has been a growing number of independent mathematical models that have been developed to address clinical and policy questions with respect to cervical cancer prevention and control but no formal efforts to compare assumptions and results across models. As part of the CISNET consortium, a group of established cervical cancer modelers from the U.S., Australia, and the Netherlands will engage in a formal collaboration of comparative modeling using a series of state-of-the-art mathematical models of HPV and cervical carcinogenesis. We will pursue analyses related to the historical impact of screening, the comparative effectiveness of current and anticipated HPV vaccination and screening strategies, and optimal routes for reducing cervical cancer disparities.

Public Health Relevance

New technologies, including screening tests and vaccines against human papillomavirus (HPV), a sexually- transmitted virus known to cause cervical cancer, are dramatically changing the landscape of cervical cancer prevention in the U.S. and worldwide. In order to address important evidence gaps in cervical cancer control, we have assembled five independent research teams who have been at the frontier of modeling cervical cancer prevention over the last decade to engage in formal comparative modeling, evaluate the comparative and cost-effectiveness of screening and vaccination strategies, and disseminate results to inform health policies and decision.

National Institute of Health (NIH)
National Cancer Institute (NCI)
Research Project--Cooperative Agreements (U01)
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Special Emphasis Panel (ZCA1)
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Scott, Susan M
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Harvard University
Public Health & Prev Medicine
Schools of Public Health
United States
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Tan, Nicholas; Sharma, Monisha; Winer, Rachel et al. (2018) Model-estimated effectiveness of single dose 9-valent HPV vaccination for HIV-positive and HIV-negative females in South Africa. Vaccine 36:4830-4836
Liu, Gui; Sharma, Monisha; Tan, Nicholas et al. (2018) HIV-positive women have higher risk of human papilloma virus infection, precancerous lesions, and cervical cancer. AIDS 32:795-808
Campos, Nicole G; Lince-Deroche, Naomi; Chibwesha, Carla J et al. (2018) Cost-Effectiveness of Cervical Cancer Screening in Women Living With HIV in South Africa: A Mathematical Modeling Study. J Acquir Immune Defic Syndr 79:195-205
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