OBJECTIVES: Based on the perspectives of health service providers and medical insurance, the economic value evidence of multi-genotype HPV detection technology in cervical cancer screening strategies was analyzed and produced, and suggestions were provided for relevant decision-making of health administrative departments and hospitals.

METHODS: The Markov cervical cancer natural outcome model was constructed by TreeAge Pro 2020, which simulated the natural process of 100,000 initial population from healthy state to cervical cancer incidence, and subdivided HPV high/medium/low risk genotypes. Cost-effectiveness analysis of HPV multi-genotype screening and HPV partial genotype (16/18 high-risk typing) screening, and the effects of sensitivity and specificity of thinprep cytologic test (TCT), colposcopy, and histopathological diagnosis cost on the economic evaluation of screening were analyzed. Besides, two strategic screening pathways are compared, we adjust the primary population state composition to observe the further results of the two strategies.

RESULTS: Taking the prevention of cervical cancer as the effect index, the effect of HPV multi-genotype is almost the same as that of partial genotypes, and the cost and the number of colposcopy examinations can be significantly reduced. As the sensitivity of TCT increases, the specificity decreases and the cost of colposcopy increases, the cost-effectiveness advantage of HPV multi-genotype over partial genotypes will increase. And with the increase in the cost of histopathological diagnosis, HPV multi-genotype has a cost-effective advantage over partial genotypes, but the advantage effect has not changed significantly. As the primary proportion of HPV51/35/39/68/56/59/66 increases, the reduction of cost and the over-screening of colposcopy are more obvious by multi-genotype screening.

CONCLUSIONS: HPV polygenic detection technology can reduce the over-utilization of medical resources to a certain extent and further improve the cost-effectiveness of screening. It has economic value in cervical cancer screening strategies.