Background: The World Health Organization aims for the global elimination of cervical cancer, necessitating modeling studies to forecast long-term outcomes.
Objective: This paper introduces a macrosimulation framework using age-period-cohort modeling and population attributable fractions to predict the timeline for eliminating cervical cancer in Taiwan.
Methods: Data for cervical cancer cases from 1997 to 2016 were obtained from the Taiwan Cancer Registry. Future incidence rates under the current approach and various intervention strategies, such as scaled-up screening (cytology based or human papillomavirus [HPV] based) and HPV vaccination, were projected.
Results: Our projections indicate that Taiwan could eliminate cervical cancer by 2050 with either 70% compliance in cytology-based or HPV-based screening or 90% HPV vaccination coverage. The years projected for elimination are 2047 and 2035 for cytology-based and HPV-based screening, respectively; 2050 for vaccination alone; and 2038 and 2033 for combined screening and vaccination approaches.
Conclusions: The age-period-cohort macrosimulation framework offers a valuable policy analysis tool for cervical cancer control. Our findings can inform strategies in other high-incidence countries, serving as a benchmark for global efforts to eliminate the disease.
Keywords: HPV; age-period-cohort model; cancer screening; cervical cancer; cervical screening; human papillomavirus; intervention; macrosimulation; population attributable fraction; public health intervention; women.
©Yi-Chu Chen, Yun-Yuan Chen, Shih-Yung Su, Jing-Rong Jhuang, Chun-Ju Chiang, Ya-Wen Yang, Li-Ju Lin, Chao-Chun Wu, Wen-Chung Lee. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 18.04.2024.