Ibáñez, RMareque, MGranados, RAndía, DGarcía-Rojo, MQuílez, J COyagüez, I2023-02-092023-02-092021-04-26http://hdl.handle.net/10668/17639HPV cervical cancer screening (CCS) must use validated HPV tests based on the molecular detection of either viral mRNA (Aptima HPV Assay-AHPV) or DNA. AHPV has demonstrated the same cross-sectional and longitudinal sensitivity for the detection of HSIL/CIN2+ lesions but with greater specificity than HPV-DNA tests. The study aimed to estimate the total costs of a CCS with a primary HPV test based on the detection of mRNA compared to DNA in women aged 35-65 years for the National Health System. A decision-tree-based model to estimate the cost of the CCS until the first colposcopy was designed based on Spanish CCS guidelines. The total cost (€, 2019) for CCS with AHPV or DNA tests (HC2 and Cobas) was calculated, including HPV test, liquid-based cytology (LBC) and colposcopy, for a population of 7,263,529 women aged 35-65 years (assuming 70% coverage). Clinical inputs derived from a literature review were validated by a multidisciplinary expert panel. Data from head-to-head studies between different HPV tests were selected. The use of AHPV showed reduction of 290,541 (- 35%) and 355,913 (- 40%) LBC compared to HC2 or Cobas, respectively. Furthermore, AHPV avoided 151,699 (- 47%) colposcopies versus HC2 and 151,165 (- 47%) versus Cobas. The total cost of CCS was € 282,747,877 with AHPV, € 322,587,588 with HC2 and € 324,614,490 with Cobas. Therefore, AHPV savings € - 39,839,711 versus HC2 and € - 41,866,613 versus Cobas. Assuming that 70% of women from 35 to 65 years attend the CCS programme, the cost of screening up to the first colposcopy using AHPV would provide cost savings of up to € 41.9 million versus DNA tests in Spain.enAttribution 4.0 Internationalhttp://creativecommons.org/licenses/by/4.0/Aptima HPV assayCervical cancer screeningCost analysisHuman papilloma virusColposcopyCosts and Cost AnalysisCross-Sectional StudiesDNA, ViralEarly Detection of CancerFemaleHumansMolecular Diagnostic TechniquesPapillomaviridaePapillomavirus InfectionsPregnancySensitivity and SpecificitySpainUterine Cervical Neoplasmsresearch article33902553open access10.1186/s12905-021-01310-81472-6874PMC8074415https://doi.org/10.1186/s12905-021-01310-8https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8074415/pdf