Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.

<h4>Objective</h4>Working in partnership with Indigenous communities in South Australia, we aimed to develop, pilot test and estimate utility scores for health states relating to cervical cancer screening, precancer, and invasive cervical cancer and precancer/cancer treatment among Indig...

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Autores principales:	Xiangqun Ju, Karen Canfell, Kirsten Howard, Gail Garvey, Joanne Hedges, Megan Smith, Lisa Jamieson
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9fd6cf3116d644ef9ec09c04632ad0a2
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spelling	oai:doaj.org-article:9fd6cf3116d644ef9ec09c04632ad0a22021-12-02T20:06:37ZPopulation-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.1932-620310.1371/journal.pone.0254575https://doaj.org/article/9fd6cf3116d644ef9ec09c04632ad0a22021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0254575https://doaj.org/toc/1932-6203<h4>Objective</h4>Working in partnership with Indigenous communities in South Australia, we aimed to develop, pilot test and estimate utility scores for health states relating to cervical cancer screening, precancer, and invasive cervical cancer and precancer/cancer treatment among Indigenous women.<h4>Methods</h4>Development and pilot testing of hypothetical cervical cancer health states, specifically through the lens of being an Indigenous Australian woman, was done with an Indigenous Reference Group in conjunction with five female Indigenous community members. Six health states were developed. These included: (1) Screened: cytology normal; (2) human papillomaviruses (HPV) positive with cytology normal; (3) low grade cytology (LSIL);(4) high grade cytology (HSIL); (5) early stage cervical cancer and; (6) later stage cervical cancer. Utility scores were calculated using a two-stage standard gamble approach among a large cohort of Indigenous Australian women taking part in a broader study involving oral HPV infection. The mean and standard deviation (SD) of the rank, percentage of respondents with a utility = 1 (perfect health) and utility score of each health state was summarised. Mean (SD) and medians and inter-quartile range (IQR) over 12 months and lifetime duration were calculated. Potential differences by age and residential location were assessed using the Wilcox Sum Rank test.<h4>Results</h4>Data was obtained from 513 Indigenous women aged 19+ years. Mean utility scores were higher for the four non-cancer health states than for invasive cervical cancer states (p-values <0.05). Lower mean utility scores were observed for late stage cervical cancer, with 0.69 at 12 months and 0.70 for lifetime duration (Intra-class correlation coefficients = 0.425). Higher utility scores were observed for the four non-cancer health states among non-metropolitan participants (ranged from 0.93 to 0.98) compared with metropolitan participants (ranged from 0.86 to 0.93) (p-values<0.05).<h4>Conclusion</h4>Among a large cohort of Indigenous Australian women, the reduction in quality of life (which utilities reflect) was perceived to be greater with increasing severity of cervical cancer health states. There were differences observed by geographic location, with positive cervical screening and precursor cancer-related quality of life being much higher among non-metropolitan-dwelling participants. These utility values, from one of the largest such studies ever performed in any population will be uniquely able to inform modelled evaluations of the benefits and costs of cervical cancer prevention interventions in Indigenous women.Xiangqun JuKaren CanfellKirsten HowardGail GarveyJoanne HedgesMegan SmithLisa JamiesonPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0254575 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Xiangqun Ju Karen Canfell Kirsten Howard Gail Garvey Joanne Hedges Megan Smith Lisa Jamieson Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.
description	<h4>Objective</h4>Working in partnership with Indigenous communities in South Australia, we aimed to develop, pilot test and estimate utility scores for health states relating to cervical cancer screening, precancer, and invasive cervical cancer and precancer/cancer treatment among Indigenous women.<h4>Methods</h4>Development and pilot testing of hypothetical cervical cancer health states, specifically through the lens of being an Indigenous Australian woman, was done with an Indigenous Reference Group in conjunction with five female Indigenous community members. Six health states were developed. These included: (1) Screened: cytology normal; (2) human papillomaviruses (HPV) positive with cytology normal; (3) low grade cytology (LSIL);(4) high grade cytology (HSIL); (5) early stage cervical cancer and; (6) later stage cervical cancer. Utility scores were calculated using a two-stage standard gamble approach among a large cohort of Indigenous Australian women taking part in a broader study involving oral HPV infection. The mean and standard deviation (SD) of the rank, percentage of respondents with a utility = 1 (perfect health) and utility score of each health state was summarised. Mean (SD) and medians and inter-quartile range (IQR) over 12 months and lifetime duration were calculated. Potential differences by age and residential location were assessed using the Wilcox Sum Rank test.<h4>Results</h4>Data was obtained from 513 Indigenous women aged 19+ years. Mean utility scores were higher for the four non-cancer health states than for invasive cervical cancer states (p-values <0.05). Lower mean utility scores were observed for late stage cervical cancer, with 0.69 at 12 months and 0.70 for lifetime duration (Intra-class correlation coefficients = 0.425). Higher utility scores were observed for the four non-cancer health states among non-metropolitan participants (ranged from 0.93 to 0.98) compared with metropolitan participants (ranged from 0.86 to 0.93) (p-values<0.05).<h4>Conclusion</h4>Among a large cohort of Indigenous Australian women, the reduction in quality of life (which utilities reflect) was perceived to be greater with increasing severity of cervical cancer health states. There were differences observed by geographic location, with positive cervical screening and precursor cancer-related quality of life being much higher among non-metropolitan-dwelling participants. These utility values, from one of the largest such studies ever performed in any population will be uniquely able to inform modelled evaluations of the benefits and costs of cervical cancer prevention interventions in Indigenous women.
format	article
author	Xiangqun Ju Karen Canfell Kirsten Howard Gail Garvey Joanne Hedges Megan Smith Lisa Jamieson
author_facet	Xiangqun Ju Karen Canfell Kirsten Howard Gail Garvey Joanne Hedges Megan Smith Lisa Jamieson
author_sort	Xiangqun Ju
title	Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.
title_short	Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.
title_full	Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.
title_fullStr	Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.
title_full_unstemmed	Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.
title_sort	population-based utility scores for hpv infection and cervical squamous cell carcinoma among australian indigenous women.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/9fd6cf3116d644ef9ec09c04632ad0a2
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Population-based utility scores for HPV infection and cervical squamous cell carcinoma among Australian Indigenous women.

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