This report summarizes estimates of health impact and cost-effectiveness of the impact of offering cervical cancer screening and HPV vaccination against types 16 and 18 on cervical cancer that were created to assess the relative value of most of the clinical preventive services recommended by the United States Preventive Services Task Force (USPSTF) and the Advisory Committee on Immunization Practices (ACIP) for the general population. This ranking of clinical prevention priorities is guided by the National Commission on Prevention Priorities (NCPP).

USPSTF Cervical Cancer Screening Recommendation: The U.S. Preventive Services Task Force updated its recommendation on cervical cancer screening in March 2012 to strongly recommend screening for cervical cancer in women aged 21-65 years with cytology (Pap smear) every three years, or for women ages 30-65 years who want to lengthen the screening interval, screening with a combination of cytology and human papillomavirus (HPV) testing every five years. This analysis assesses screening the general population of women aged 21-65 using Pap smears and does not assess the alternate screening interval with use of HPV testing.

The USPSTF found good evidence that screening for cervical cancer using Pap smears reduces mortality from and the incidence of cervical cancer. The USPSTF found no direct evidence that annual or biannual screening with Pap smears is more effective than triennial screening. The existing effectiveness literature, to which we have calibrated our simulation model, includes populations who were offered screening every two to five years. Our base-case model assumes triennial screening recommendation with Pap smear starting at the latest of age 21 or the onset of sexual activity. Within the model, a positive Pap smear is followed by a confirmatory Pap smear with HPV DNA test prior to final diagnosis and treatment. The estimates in this report may not reflect current USPSTF recommendations. Readers are advised to check for updated recommendations at https://uspreventiveservicestaskforce.org.