Comparative Modeling to Inform Cervical Cancer Control Policies

项目摘要 尽管在美国（US）成功进行了宫颈癌筛查，但仍有超过13，000名妇女患上宫颈癌， 每年都有妇女死于宫颈癌。人乳头瘤病毒（HPV）的发现是必要的 宫颈癌的病因促使了新证据的激增，并开发了基于HPV的创新疗法。 技术，包括筛查和预防性疫苗接种，使我们的生活发生了重大变化， 在过去的二十年里，宫颈癌的控制方法。这些新技术代表了 有效的机会，公平，高效的宫颈癌计划在美国，但也构成重大 决策的挑战。鉴于新筛查的结局数据有限， 从实证研究的疫苗接种方法，政策制定者已经成为独特的依赖数学 建模，为宫颈癌控制策略的决策提供综合证据基础。 这些模型可用于整合最新数据，将短期发现外推到长期 结果，并评估假设情景，否则将是不切实际或不可行的进行， 临床研究。拟议的CISNET项目将代表五个机构继续开展富有成效的合作， 来自美国、澳大利亚和荷兰的独立模特团体，将利用一系列州- HPV和宫颈癌发生的最先进的数学模型进行比较建模。我们将奉行 与新修订的筛查和HPV疫苗接种指南的影响相关的分析， 即将到来的筛查和HPV疫苗接种策略和方法的有效性， 减少宫颈癌的差异，在美国消除宫颈癌的潜力， 艾滋病毒感染妇女的筛查和疫苗接种战略。我们的努力还将包括广泛传播 向各利益攸关方提供调查结果，以提高基于模型的分析的透明度和信心。

Project Summary Despite successful cervical cancer screening in the United States (US), over 13,000 women develop and 4,000 women die from cervical cancer each year. The discovery of human papillomavirus (HPV) as the necessary cause of cervical cancer precipitated a surge of new evidence and development of innovative HPV-based technologies, both screening and prophylactic vaccination, that have allowed for significant changes in our approach to cervical cancer control over the past two decades. These new technologies represent tremendous opportunities for effective, equitable, and efficient cervical cancer programs in the US but also pose significant challenges for decision-making. Given the limited availability of outcomes data for new screening and vaccination approaches from empirical studies, policy-makers have become uniquely reliant on mathematical modeling to provide a synthesized evidence base for decision-making for cervical cancer control strategies. These models can be used to integrate the most up-to-date data, extrapolate short-term findings into long-term outcomes, and evaluate what-if scenarios that would otherwise be impractical or infeasible to conduct in clinical studies. The proposed CISNET project will represent the continued, productive collaboration of five independent modeling groups from the US, Australia, and the Netherlands that will leverage a series of state- of-the-art mathematical models of HPV and cervical carcinogenesis for comparative modeling. We will pursue analyses related to the impact of newly-revised screening and HPV vaccination guidelines, the comparative effectiveness of forthcoming screening and HPV vaccination strategies and approaches, the optimal routes for reducing cervical cancer disparities, the potential for cervical cancer elimination in the US, and optimal screening and vaccination strategies in women living with HIV. Our efforts will also involve wide dissemination of findings to various stakeholders to increase transparency and confidence in model-based analyses.