DETERMINATION OF UTILITY FUNCTIONS AS AN EVALUATION CRITERIA FOR PRIMARY CERVICAL SCREENING STRATEGIES OF HPV-ASSOCIATED CERVICAL PATHOLOGIES

Background. Cervical cancer (CC) ranks second place among cancers of women of reproductive age inUkraine, accounting for more than 2000 deaths annually. Virtually all cases of CCs are caused by persistent infection with Human Papillomaviruses (HPVs). Two main methods of diagnosis in screening for cervical pathology are cytological test (Pap-test) and molecular-genetic test (HPV-test). Implementation of efficient CC screening programs, based on Pap- and HPV-tests, might significantly decrease CC incidence rates. Issue of effective combination of the two diagnostic methods and development of optimal screening strategies is essential.

Objective. To determine utility functions for HPV- and cytological tests based on clinical and laboratory research data from women of all age groups inUkraine.

Materials and methods. Cytological (Pap-test) and molecular-genetic (HPV-test) methods, statistical analysis, mathematical modeling approaches.

Results. Data on the prevalence of HPV-infections and HPV-associated cervical pathologies formed the basis for the utility functions mathematical modeling of the main methods of CC screening strategies. The utility functions for cytological and HPV-tests were assessed, showing significant utility differences depending on the age of the patient and the combination of used methods. The utility functions of both tests considered as components of a single strategy showed screening relevance of implementation of HPV-test in women aged 18–21 years and cytological test utility in the population of older women.

Conclusions. The results enable comprehensive evaluation of possible cervical screening strategies based on molecular-epidemiologic data of HPV-infections inUkraine.