PMID- 34292987
OWN - NLM
STAT- MEDLINE
DCOM- 20211110
LR  - 20211204
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 16
IP  - 7
DP  - 2021
TI  - Population-based utility scores for HPV infection and cervical squamous cell 
      carcinoma among Australian Indigenous women.
PG  - e0254575
LID - 10.1371/journal.pone.0254575 [doi]
LID - e0254575
AB  - OBJECTIVE: 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. METHODS: 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. RESULTS: 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). CONCLUSION: 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.
FAU - Ju, Xiangqun
AU  - Ju X
AUID- ORCID: 0000-0003-4759-3918
AD  - Adelaide Dental School, Australian Research Centre for Population Oral Health, 
      The University of Adelaide, Adelaide, Australia.
FAU - Canfell, Karen
AU  - Canfell K
AD  - Cancer Council of NSW, Sydney, Australia.
AD  - School of Public Health, The University of Sydney, Sydney, Australia.
FAU - Howard, Kirsten
AU  - Howard K
AD  - School of Public Health, The University of Sydney, Sydney, Australia.
FAU - Garvey, Gail
AU  - Garvey G
AD  - Menzies School of Health Research, Tiwi, Australia.
FAU - Hedges, Joanne
AU  - Hedges J
AD  - Adelaide Dental School, Australian Research Centre for Population Oral Health, 
      The University of Adelaide, Adelaide, Australia.
FAU - Smith, Megan
AU  - Smith M
AD  - Cancer Council of NSW, Sydney, Australia.
AD  - School of Public Health, The University of Sydney, Sydney, Australia.
FAU - Jamieson, Lisa
AU  - Jamieson L
AD  - Adelaide Dental School, Australian Research Centre for Population Oral Health, 
      The University of Adelaide, Adelaide, Australia.
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20210722
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Adult
MH  - Australia/epidemiology
MH  - Carcinoma, Squamous Cell/*epidemiology
MH  - Female
MH  - Humans
MH  - Middle Aged
MH  - *Native Hawaiian or Other Pacific Islander
MH  - Neoplasm Staging
MH  - Papillomavirus Infections/*epidemiology
MH  - *Quality of Life
MH  - Uterine Cervical Neoplasms/*epidemiology
PMC - PMC8298063
COIS- The authors confirm that they have no competing interests.
EDAT- 2021/07/23 06:00
MHDA- 2021/11/11 06:00
PMCR- 2021/07/22
CRDT- 2021/07/22 17:25
PHST- 2020/08/28 00:00 [received]
PHST- 2021/06/29 00:00 [accepted]
PHST- 2021/07/22 17:25 [entrez]
PHST- 2021/07/23 06:00 [pubmed]
PHST- 2021/11/11 06:00 [medline]
PHST- 2021/07/22 00:00 [pmc-release]
AID - PONE-D-20-26869 [pii]
AID - 10.1371/journal.pone.0254575 [doi]
PST - epublish
SO  - PLoS One. 2021 Jul 22;16(7):e0254575. doi: 10.1371/journal.pone.0254575. 
      eCollection 2021.