Parameter Group | Study Selection Criteria |
---|---|
General criteria for stud y selection | • Nationally representative studies meeting selection criteria |
 |    ➢ If unavailable, then select broad population-based studies |
 | ▪ If unavailable, then select local studies |
 | • Specificity of results to HPV type groupings of interest (16/18 or 6/11) |
 |    ➢ If studies specific to HPV 16/18 or 6/11 infection or disease are unavailable, then select studies of all high-risk or all low-risk HPV types, respectively |
 | ▪ If unavailable then select studies for all infections or disease |
 | • PCR-based methods for HPV detection in infections |
Progression of HPV infection and disease | • Histologic confirmation of cervical disease |
 | • Data available for outcomes reported over a 12-month time horizon |
HPV infection mean duration in absence of detectable disease | • Specificity of results to HPV type groupings of interest (16/18 or 6/11) |
 | • Truncation of infection duration at time of disease detection via histology |
 | • Limited degree of censoring beyond longest infection follow-up time |
Regression of HPV infection and disease | • Histologic confirmation of cervical disease at baseline |
 | • Biopsy confirmation of cervical HPV-type specific disease absence during follow-up to connote regression |
 |    ➢ If unavailable for all cases, then select studies with either biopsy confirmed HPV-type specific disease absence for a portion of cases, with negative cytology for non-biopsied cases, OR biopsy confirmed disease absence, irrespective of HPV-type |
 | • Data available for outcomes reported over a 12-month time horizon |
Cervical cancer mortality | • Data available on an age- and stage-specific basis |
 | • Nationally representative or broad population-based studies in unscreened women |
 |    ➢ If unavailable, then select nationally representative or broad population-based studies in screened and unscreened women |
 | • Data available for outcomes reported over a 12-month time horizon |
Hysterectomy for non-HPV related conditions | • Age-specific annual hysterectomy rates reported |
Cytology screening rates | • Age-specific annual routine cervical cytology screening rates reported |
 |    ➢ Routine screening reported separately from follow-up screening |
 |    ➢ Cervical cytology reported separately from vaginal cytology |
 | • Data based on documented screening utilization in a population-based study if available |
 |    ➢ If unavailable, then select studies based on patient self-report |
Cytology sensitivity | • Liquid-based cytology evaluated |
 | • Cervical biopsy performed on all women |
 |    ➢ If unavailable, then select studies in which cervical biopsy was performed on at least a random sample of women with negative cytology and colposcopy results |
Cytology specificity | • Liquid-based cytology evaluated |
 | • Cervical colposcopy performed on all women, with biopsy performed if abnormalities suspected |
 | • Biopsy results reported for all grades of cervical disease (≥ CIN 1) |
Colposcopy sensitivity/specificity | • Colposcopy performed following abnormal cytology |
 | • Colposcopically directed cervical biopsy performed on all women |
 | • Biopsy results reported for all grades of cervical disease (≥ CIN 1) |
Symptom development among cancer patients | • Stage-specific symptom development |
 | • Representative cross-section of patients with cervical cancer at each stage including patients who may harbor occult cancers |
 |    ➢ If unavailable, then rely upon expert opinion from the literature |
Eradication of CIN with treatment | • Representative study of CIN therapies used in practice if available |
 |    ➢ If unavailable then select studies of LEEP (most common modality) |
 | • Stratified reporting of outcomes by pre-treatment CIN grade |
 | • Post-treatment follow-up of all women within 12 months via colposcopy and/or biopsy |
 | • Definition of recurrent or residual disease as CIN 1 or more severe histology |
Eradication of cervical cancer with treatment | • Nationally representative or broad population-based studies of 5-year disease-free survival by cancer stage |
 |    ➢ If unavailable, then select nationally representative or broad population-based studies of 5-year relative survival by cancer stage |
Eradication of genital warts with treatment | • Representative study of genital wart treatments used in clinical practice |
 | • Physician ascertained clearance following treatment for all subjects |
Persistence of HPV following cervical disease eradication | • Representative study of therapies used in practice if available |
 |    ➢ If unavailable, then select studies of LEEP (most common modality) for CIN, and hysterectomy or radiation therapy for cervical cancer |
 | • Histologic confirmation of disease pre-treatment and post-treatment (for exclusionary study purposes) |
 | • HPV typing of pre- or post-treatment lesion tissue specimens or both |
 |    ➢ If unavailable, then select studies with HPV typing of any cervical specimen |
 | • Follow-up for all women within 6 months post-treatment |
 |    ➢ If unavailable, then select studies with less prompt follow-up |
 | • Colposcopy performed on all women post-treatment to assist in confirming disease eradication |
Persistence of HPV following genital wart eradication | • Representative study of genital wart treatments used in clinical practice |
 | • Testing for HPV infection across a range of anogenital sites post-treatment (not just at the former wart site) |
 | • Follow-up for all women within 6 months post-treatment |
 |    ➢ If unavailable, then select studies with less prompt follow-up |
Care seeking behavior for genital warts | • Population-based studies of patients with genital warts, including both those who have, and who have not, chosen to seek physician care |
 |    ➢ If unavailable, then rely upon expert opinion from the literature |