title: Estimating progression rates for human papillomavirus infection from epidemiological data.
abstract: A Markov model was constructed in order to estimate type-specific rates of cervical lesion progression and regression in women with high-risk human papillomavirus (HPV). The model was fitted to age- and type-specific data regarding the HPV DNA and cytological status of women undergoing cervical screening in a recent screening trial, as well as cervical cancer incidence. It incorporates different assumptions about the way lesions regress, the accuracy of cytological screening, the specificity of HPV DNA testing, and the age-specific prevalence of HPV infection. Combinations of assumptions generate 162 scenarios for squamous cell carcinomas and 54 scenarios for adenocarcinomas. Simulating an unscreened cohort of women infected with high-risk HPV indicates that the probability of an infection continuing to persist and to develop into invasive cancer depends on the length of time it has already persisted. The scenarios and parameter sets that produce the best fit to available epidemiological data provide a basis for modeling the natural history of HPV infection and disease.
authors.affiliation: Modelling and Economics Unit, Health Protection Agency Centre for Infections, London, United Kingdom. mark.jit@hpa.org.uk
authors.forename: Mark
authors.initials: M
authors.lastname: Jit
authors.forename: Nigel
authors.initials: N
authors.lastname: Gay
authors.forename: Kate
authors.initials: K
authors.lastname: Soldan
authors.forename: Yoon
authors.initials: Y
authors.lastname: Hong Choi
authors.forename: William John
authors.initials: WJ
authors.lastname: Edmunds
mesh_terms: D000328:Adult; D018450:Disease Progression; D055088:Early Detection of Cancer; D004739:England / Q000453:epidemiology; D005260:Female; D052162:Human papillomavirus 16 / Q000302:isolation & purification / Q000472:pathogenicity; D052161:Human papillomavirus 18 / Q000302:isolation & purification / Q000472:pathogenicity; D006801:Humans; D008390:Markov Chains; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology; D035501:Uncertainty; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000503:physiopathology; D014852:Wales / Q000453:epidemiology; D055815:Young Adult