Pathways to a cancer-free future: A protocol for modelled evaluations to maximize the future impact of interventions on cervical cancer in Australia

Louiza S. Velentzis, Megan A. Smith, Kate T. Simms, Michaela Hall, Suzanne Hughes, Susan Yuill, James Killen, Adam Keane, Katherine Butler, Jessica Darlington-Brown, Harriet Hui, Julia M. L. Brotherton, Rachel Skinner, Alison Brand, Lara Roeske, Stella Heley, Jonathan Carter, Deborah Bateson, Ian Frazer, Suzanne M. GarlanRebecca Guy, Ian Hammond, Paul Grogan, Marc Arbyn, Philip E. Castle, Marion Saville, Bruce K. Armstrong, Karen Canfell

Research output: Contribution to journalArticlepeer-review

14 Citations (Web of Science)


Objective. Australia's HPV vaccination and HPV-based cervical screening programs are changing the landscape in cervical cancer prevention. We aim to identify areas which can make the biggest further impact on cervical cancer burden. This protocol describes the first stage of a program of work called Pathways-Cervix that aims to generate evidence from modelled evaluations of interventions across the cervical cancer spectrum.

Methods. Based on evidence from literature reviews and guidance from a multi-disciplinary Scientific Advisory Committee (SAC), the most relevant evaluations for prevention, diagnosis and treatment were identified.

Results. Priority evaluations agreed by the SAC included: increasing/decreasing and retaining vaccination uptake at the current level; vaccinating older women; increasing screening participation; methods for triaging HPVpositive women; improving the diagnosis of cervical intraepithelial neoplasia (CIN) and cancer; treating cervical abnormalities and cancer; and vaccinating women treated for CIN2/3 to prevent recurrence. Evaluations will be performed using a simulation model, Policy]-Cervix previously used to perform policy evaluations in Australia. Exploratory modelling of interventions using idealised scenarios will initially be conducted in single birth cohorts. If these have a significant impact on findings then evaluations with more realistic assumptions will be conducted. Promising strategies will be investigated further by multi-cohort simulations predicting health outcomes, resource use and cost outcomes.

Conclusions. Pathways-Cervix will assess the relative benefits of strategies and treatment options in a systematic and health economic framework, producing a list of 'best buys' for future decision-making in cervical cancer control. (C) 2018 Published by Elsevier Inc.

Original languageEnglish
Pages (from-to)465-471
Number of pages7
JournalGynecologic Oncology
Issue number3
Publication statusPublished - Mar 2019


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