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Table 3 Annual CC cases and change from the pre-vaccination situation under the optimal budget allocation

From: Modeling optimal cervical cancer prevention strategies in Nigeria

Sensitivity analyses scenario

Screening and vaccine coverage constraints

 

20% screening, 95% vaccination

40% screening, 95% vaccination

20% screening, 50% vaccination

Base case (3 doses)

   

Base case—mean treatment costs and one lifetime screening

12.0 (-31%)

11.6 (-34%)

12.1 (-31%)

Prevention cost minus 20% and CIN treatment costs minus 1 SD

11.6 (-34%)

10.8 (-38%)

12.3 (-29%)

Prevention costs plus 20% and CIN treatment costs plus 1 SD

12.3 (-29%)

12.3 (-29%)

12.1 (-31%)

CC treatment costs minus 1 SD

10.7 (-38%)

10.4 (-40%)

11.7 (-33%)

CC treatment costs plus 1 SD

13.5 (-23%)

13.1 (-25%)

13.5 (-23%)

Allow scenarios with two lifetime screenings

12.0 (-31%)

11.6 (-34%)

12.1 (-30%)

Allow scenarios with two or three lifetime screenings

12.0 (-31%)

11.6 (-34%)

12.1 (-31%)

Screening using HPV test

11.6 (-34%)

10.8 (-38%)

12.0 (-31%)

Vaccine (3 doses) duration of protection = 25 years, vaccine efficacy reduced by 20%

12.8 (-27%)

12.3 (-30%)

13.1 (-25%)

Alternative scenario (2 doses) *

   

Base case mean treatment costs and one lifetime screening

9.4 (-46%)

9.4 (-46%)

11.0 (-37%)

Prevention cost minus 20% and CIN treatment costs minus 1 SD

8.8 (-50%)

8.4 (-52%)

11.0 (-37%)

Prevention costs plus 20% and CIN treatment costs plus 1 SD

9.4 (-46%)

9.4 (-46%)

11.1 (-36%)

CC treatment costs minus 1 SD

7.9 (-55%)

7.9 (-55%)

11.0 (-37%)

CC treatment costs plus 1 SD

11.4 (-35%)

11.4 (-35%)

11.6 (-33%)

Allow scenarios with two lifetime screenings

9.4 (-46%)

9.4 (-46%)

11.0 (-37%)

Allow scenarios with two or three lifetime screenings

9.4 (-46%)

9.4 (-46%)

11.0 (-37%)

Screening using HPV test

8.8 (-49%)

8.5 (-51%)

11.3 (-35%)

Vaccine (2 doses) duration of protection = 25 years, vaccine efficacy reduced by 20%

10.8 (-38%)

10.6 (-39%)

12.3 (-29%)

  1. Sensitivity analyses: budget constraint $1 (~4 times pre-vaccination budget) per woman.
  2. V-S(int)-V&S-None.
  3. CIN = Cervical intraepithelial neoplasia; CC = Cervical cancer; SD = Standard deviation.
  4. *assume, in the base case, the same efficacy for a three or a two dose vaccine.