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Consecutive and population-based HPV genotyping data of cervical cancers will establish a baseline of the HPV type-specific disease burden as basis for optimising cervical cancer prevention strategies and enable a later comparison after the switch to primary HPV screening and/or implementation of new vaccination strategies.
If there are too many faecaliths, 3D becomes time-consuming and it is better to switch to primary 2D read.
23 However, new management strategies should also be studied, particularly if considering a switch to primary HPV testing.
We conclude that in Norway, strategies involving a switch to primary HPV testing in older women is expected to be cost-effective compared with the current cytology-based screening programme.
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New screening strategies of particular interest include delaying the start age of screening, increasing the screening interval and switching to primary HPV screening.
We found that switching to primary HPV DNA testing at age 31 dominated switching at age 34, one screening episode earlier than suggested by the Norwegian proposal.
Current cytology-only screening was less effective and more costly than strategies that involve switching to primary HPV testing in older ages.
In the primary analysis and regardless of vaccination status, the current cytology-based screening strategy was less effective and more costly (i.e., strongly dominated) than proposed strategies that involve switching to primary HPV testing at 34 years of age.
For unvaccinated women 34 years or older, switching to primary HPV DNA testing with a 4-year screening interval was found optimal in the majority of the simulations (58%), whereas a 6-year screening interval was never preferred.
Though as many as 20 states switched to primaries between 1910 and 1920, Iowa saw no need for reform.
It limits the pool of available participants, which is why the Democratic Party began switching to primaries after 1972, opening things up to the rank-and-file.
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