Outcomes
SECONDARY, CERVICAL CANCER
Using EMR data, 2 primary outcomes were assessed in the HOME trial: histologically diagnosed CIN2+ and treated CIN2+. Diagnosed CIN2+ was captured within 6 months after an abnormal screening result that occurred within 6 months after randomization, and treated CIN2+ was captured within 6 months after a diagnosis of CIN2+. Each participant was followed up to 18 months after randomization.The current economic evaluation focused on the secondary HOME trial outcome of screening uptake, which was captured by the receipt of cervical cancer screening within 6 months after randomization and defined as receiving (1) in-clinic screening, (2) a positive HPV-16 or HPV-18 result on a self-sampled HPV test, (3) a negative result on a self-sampled HPV test, or (4) a positive result on a self-sampled HPV test for types other than HPV-16 or HPV-18 or an unsatisfactory result on subsequent in-clinic screening. This definition of screening uptake allowed either modality (self-sampling kit or in-clinic screening) to count as an outcome. Focusing on an intermediate outcome, such as screening uptake, was deemed more salient to US-based health care systems and payers. The primary outcome of this economic evaluation was the incremental cost-effectiveness ratio (ICER) for screening uptake.