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  1. Article ; Online: Factors associated with parental Human Papillomavirus (HPV) vaccination intention of daughter: A national survey in Finland.

    Hussein, Idil / Vänskä, Simopekka / Sivelä, Jonas / Leino, Tuija / Nohynek, Hanna

    Vaccine

    2024  Volume 42, Issue 3, Page(s) 701–712

    Abstract: Background: Human papillomavirus (HPV) vaccines are offered free of charge in Finland to 10-12-year-old children. Nationally about 80% of girls are vaccinated, with regional differences in first dose coverage varying from 62% to 82% in girls born in ... ...

    Abstract Background: Human papillomavirus (HPV) vaccines are offered free of charge in Finland to 10-12-year-old children. Nationally about 80% of girls are vaccinated, with regional differences in first dose coverage varying from 62% to 82% in girls born in 2011. This study examined the factors associated with HPV vaccination intention. Furthermore, we assessed the realisation of HPV vaccination among the daughters of the participating parents.
    Methods: A web-based survey was conducted for randomly selected parents of girls (N = 6 465) aged 10 to 14 years of age. Data was collected in February and March 2022 in five Finnish high and low coverage municipalities. The national vaccination register was employed to assess realisation of vaccination.
    Results: Participation rate was 13.7% (n = 883 parents). Almost all parents were aware of the association between HPV and cervical cancer, but only one fifth was aware of other diseases associated with HPV. Adherence to the national vaccination programme, parents' mother tongue, and trusting in official information were associated with positive vaccination intention. The most often reported reason for non-vaccination was fear of adverse effects (22%). Overall, parental attitudes towards HPV vaccination were positive, with 83% of parents indicating their daughter had received or will receive the vaccination. Vaccination realisation was subsequently examined and 88% of the daughters were vaccinated.
    Conclusions: Despite low knowledge of HPV-related diseases overall, majority of parents held a positive intention to vaccinate their daughter. Realisation of intention was high in our study, higher than the national uptake. Foreign-origin parents had lower intention to vaccinate their daughters. As information on HPV and its vaccine is available in 11 languages, there is a need to re-think accessibility. In-depth interviews are needed to better explore the reasons behind non-vaccination.
    MeSH term(s) Female ; Child ; Humans ; Adolescent ; Nuclear Family ; Finland ; Intention ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines ; Vaccination ; Human Papillomavirus Viruses ; Parents ; Patient Acceptance of Health Care ; Health Knowledge, Attitudes, Practice
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2024-01-03
    Publishing country Netherlands
    Document type Journal Article
    ZDB-ID 605674-x
    ISSN 1873-2518 ; 0264-410X
    ISSN (online) 1873-2518
    ISSN 0264-410X
    DOI 10.1016/j.vaccine.2023.12.026
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The confounding effect of multi-type human papillomavirus infections on type-specific natural history parameter identification.

    Suomenrinne-Nordvik, Anna / Vänskä, Simopekka

    Epidemics

    2021  Volume 36, Page(s) 100468

    Abstract: The natural history of human papillomavirus (HPV) from infection to cervical cancer differs between HPV types. Accordingly, type-specific natural history parameters are crucial for the mathematical models used to optimize the nearly life-long series of ... ...

    Abstract The natural history of human papillomavirus (HPV) from infection to cervical cancer differs between HPV types. Accordingly, type-specific natural history parameters are crucial for the mathematical models used to optimize the nearly life-long series of disease prevention measures. These parameters are estimated from genotyped data from trials and population level screening programs, typically one type at a time, which requires projecting the multiple-type data to the single type. To analyze impacts of such projection methods on the estimates, we compared estimating one type at a time using different projection methods with estimating all types together. We simulated genotyped data with chosen parameter values for two HPV types and analyzed the identifiability of the chosen values using the different estimation methods. We found the success of estimating one type at a time to be excessively sensitive to the data projection method, with potential to falsely identify the parameters at wrong values. Estimating all types together identified the parameters well. Our results were consistent both when trial and population level data were used. In conclusion, the potential confounding by multi-type infections has to be considered when choosing an estimation method for type-specific natural history parameters.
    MeSH term(s) Female ; Genotype ; Humans ; Models, Theoretical ; Papillomaviridae/genetics ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/genetics ; Uterine Cervical Neoplasms
    Language English
    Publishing date 2021-06-24
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2467993-8
    ISSN 1878-0067 ; 1755-4365
    ISSN (online) 1878-0067
    ISSN 1755-4365
    DOI 10.1016/j.epidem.2021.100468
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Factors associated with parental intention to vaccinate their child against influenza, Finland, February to March, 2022: a web-based survey.

    Hussein, Idil / Vänskä, Simopekka / Sivelä, Jonas / Leino, Tuija / Nohynek, Hanna

    Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin

    2023  Volume 28, Issue 49

    Abstract: BackgroundInfluenza vaccination for children aged 6 months to 6 years is included in the national vaccination programme in Finland. Although all vaccines in the programme are free of charge, national coverage of influenza vaccination among children under ...

    Abstract BackgroundInfluenza vaccination for children aged 6 months to 6 years is included in the national vaccination programme in Finland. Although all vaccines in the programme are free of charge, national coverage of influenza vaccination among children under 3 years and 3-6 years during 2020/21 was 43% and 35% respectively, with regional differences.AimTo assess factors underlying parental vaccination intention in order to increase influenza vaccine uptake among children.MethodsWe conducted a web-based survey among parents (n = 17,844) of randomly selected eligible children (aged 6 months-6 years) in February-March 2022 in five Finnish municipalities from regions of high and low coverage. Logistic regressions were used to determine associations between vaccination intention and e.g. sociodemographic factors, attitudes and knowledge. Linkage to the national vaccination register was used to confirm realisation of vaccination intention after the study.ResultsParticipation rate was 13% (n = 2,322 parents). Influenza knowledge, trust in official information, responding parent's education level, adherence to the vaccination programme, number of children and changes in attitudes towards vaccination since COVID-19 were all associated with intention to vaccinate. Vaccination intention for children was 64%, and realised vaccination 51%.ConclusionDespite the low participation rate, both vaccinated and unvaccinated children were represented. Influenza vaccine uptake is not dependent on a single factor. Our results identified the need for open dialogue between parents and healthcare professionals, as the lack of vaccine being offered by healthcare professionals was the most reported reason for not vaccinating.
    MeSH term(s) Child ; Humans ; Child, Preschool ; Influenza Vaccines ; Influenza, Human/epidemiology ; Influenza, Human/prevention & control ; Finland/epidemiology ; Intention ; Vaccination ; Health Knowledge, Attitudes, Practice ; Parents ; Internet
    Chemical Substances Influenza Vaccines
    Language English
    Publishing date 2023-12-08
    Publishing country Sweden
    Document type Journal Article
    ZDB-ID 1338803-4
    ISSN 1560-7917 ; 1025-496X
    ISSN (online) 1560-7917
    ISSN 1025-496X
    DOI 10.2807/1560-7917.ES.2023.28.49.2200828
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  4. Article ; Online: In 30 years, gender-neutral vaccination eradicates oncogenic human papillomavirus (HPV) types while screening eliminates HPV-associated cancers.

    Lehtinen, Matti / Gray, Penelope / Louvanto, Karolina / Vänskä, Simopekka

    Expert review of vaccines

    2022  Volume 21, Issue 6, Page(s) 735–738

    MeSH term(s) Alphapapillomavirus ; Early Detection of Cancer ; Female ; Humans ; Neoplasms/prevention & control ; Papillomaviridae ; Papillomavirus Infections/complications ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/prevention & control ; Vaccination
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2022-04-15
    Publishing country England
    Document type Editorial ; Research Support, Non-U.S. Gov't
    ZDB-ID 2181284-6
    ISSN 1744-8395 ; 1476-0584
    ISSN (online) 1744-8395
    ISSN 1476-0584
    DOI 10.1080/14760584.2022.2064279
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  5. Article ; Online: Scientific approaches toward improving cervical cancer elimination strategies.

    Lehtinen, Matti / Bruni, Laia / Elfström, Miriam / Gray, Penelope / Logel, Margaret / Mariz, Filipe Colaço / Baussano, Iacopo / Vänskä, Simopekka / Franco, Eduardo L / Dillner, Joakim

    International journal of cancer

    2024  Volume 154, Issue 9, Page(s) 1537–1548

    Abstract: At the 2023 EUROGIN workshop scientific basis for strategies to accelerate the elimination of cervical cancer and its causative agent, human papillomavirus (HPV) were reviewed. Although some countries have reached key performance indicators toward ... ...

    Abstract At the 2023 EUROGIN workshop scientific basis for strategies to accelerate the elimination of cervical cancer and its causative agent, human papillomavirus (HPV) were reviewed. Although some countries have reached key performance indicators toward elimination (>90% of girls HPV vaccinated and >70% of women HPV screened), most are yet to reach these targets, implying a need for improved strategies. Gender-neutral vaccination, even with moderate vaccination coverage was highlighted as a strategy to achieve elimination more rapidly. It is more resilient against major disturbances in vaccination delivery, such as what happened during the coronavirus pandemic. Further, an analysis of ethical/legal issues indicated that female-restricted vaccination is problematic. Extended catch-up of vaccination with concomitant screening, and outreach to vulnerable groups were highlighted. Although birth cohorts with high coverage of HPV vaccination at school are protected against HPV, and HPVs have a very low reproductive rate in women above age 35, adult women below age 30 have inadequate direct protection. In addition to herd protection from gender-neutral vaccination, this group can be protected by offering concomitant catch-up HPV vaccination and HPV screening. Furthermore, hepatitis B vaccination experiences indicate that elimination cannot be achieved without prioritizing vulnerable/migrant populations. The long-lasting durability of vaccination-induced antibody responses suggests prolonged protection with HPV vaccines when adequately administrated. Finally, cost-effectiveness modelling suggests that high-coverage HPV vaccination in multiple population segments will be resource-saving due to reduced need for screening. In summary, the workshop found that strategically optimal deployment of vaccination will accelerate elimination of HPV and cervical cancer.
    MeSH term(s) Adult ; Humans ; Female ; Uterine Cervical Neoplasms/epidemiology ; Uterine Cervical Neoplasms/prevention & control ; Uterine Cervical Neoplasms/diagnosis ; Papillomavirus Infections ; Papillomavirus Vaccines/therapeutic use ; Mass Screening ; Vaccination
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2024-01-09
    Publishing country United States
    Document type Journal Article
    ZDB-ID 218257-9
    ISSN 1097-0215 ; 0020-7136
    ISSN (online) 1097-0215
    ISSN 0020-7136
    DOI 10.1002/ijc.34839
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  6. Article ; Online: Human Papillomavirus Genotype Replacement: Still Too Early to Tell?

    Man, Irene / Vänskä, Simopekka / Lehtinen, Matti / Bogaards, Johannes A

    The Journal of infectious diseases

    2020  Volume 224, Issue 3, Page(s) 481–491

    Abstract: Background: Although human papillomavirus (HPV) vaccines are highly efficacious in protecting against HPV infections and related diseases, vaccination may trigger replacement by nontargeted genotypes if these compete with the vaccine-targeted types. HPV ...

    Abstract Background: Although human papillomavirus (HPV) vaccines are highly efficacious in protecting against HPV infections and related diseases, vaccination may trigger replacement by nontargeted genotypes if these compete with the vaccine-targeted types. HPV genotype replacement has been deemed unlikely, based on the lack of systematic increases in the prevalence of nonvaccine-type (NVT) infection in the first decade after vaccination, and on the presence of cross-protection for some NVTs.
    Methods: To investigate whether type replacement can be inferred from early postvaccination surveillance, we constructed a transmission model in which a vaccine type and an NVT compete through infection-induced cross-immunity. We simulated scenarios of different levels of cross-immunity and vaccine-induced cross-protection to the NVT. We validated whether commonly used measures correctly indicate type replacement in the long run.
    Results: Type replacement is a trade-off between cross-immunity and cross-protection; cross-immunity leads to type replacement unless cross-protection is strong enough. With weak cross-protection, NVT prevalence may initially decrease before rebounding into type replacement, exhibiting a honeymoon period. Importantly, vaccine effectiveness for NVTs is inadequate for indicating type replacement.
    Conclusions: Although postvaccination surveillance thus far is reassuring, it is still too early to preclude type replacement. Monitoring of NVTs remains pivotal in gauging population-level impacts of HPV vaccination.
    MeSH term(s) Alphapapillomavirus/genetics ; Genotype ; Humans ; Papillomaviridae/genetics ; Papillomaviridae/immunology ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines ; Vaccine Efficacy
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2020-01-23
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 3019-3
    ISSN 1537-6613 ; 0022-1899
    ISSN (online) 1537-6613
    ISSN 0022-1899
    DOI 10.1093/infdis/jiaa032
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  7. Article ; Online: Eradication of human papillomavirus and elimination of HPV-related diseases - scientific basis for global public health policies.

    Lehtinen, Matti / Baussano, Iacopo / Paavonen, Jorma / Vänskä, Simopekka / Dillner, Joakim

    Expert review of vaccines

    2019  Volume 18, Issue 2, Page(s) 153–160

    Abstract: Introduction: Infections with oncogenic human papillomaviruses (HPV) globally cause about 9% of cancers in females and 1% of cancers in males. HPV disease burden can be effectively controlled by prophylactic HPV-vaccination provided it has high impact.!# ...

    Abstract Introduction: Infections with oncogenic human papillomaviruses (HPV) globally cause about 9% of cancers in females and 1% of cancers in males. HPV disease burden can be effectively controlled by prophylactic HPV-vaccination provided it has high impact.
    Areas covered: A unique series of biobank-based and health registry-based studies that exploit randomized intervention cohorts has provided data on population-level safety of HPV vaccination, duration of vaccine-induced protection and impact of gender-neutral HPV vaccination, providing a scientific basis for policies to eradicate oncogenic HPV types and associated diseases worldwide.
    Expert commentary: The ultimate goal of HPV vaccination is the eradication of high-risk (hr) HPVs. Seventy-five percent coverage gender-neutral vaccination of early adolescents will rapidly eradicate also HPV16 from the general population.
    MeSH term(s) Adolescent ; Animals ; Female ; Global Health ; Health Policy ; Human papillomavirus 16/isolation & purification ; Humans ; Male ; Neoplasms/epidemiology ; Neoplasms/prevention & control ; Neoplasms/virology ; Papillomaviridae/isolation & purification ; Papillomavirus Infections/complications ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines/administration & dosage ; Vaccination/methods ; Vaccination Coverage
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2019-02-07
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 2181284-6
    ISSN 1744-8395 ; 1476-0584
    ISSN (online) 1744-8395
    ISSN 1476-0584
    DOI 10.1080/14760584.2019.1568876
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  8. Article ; Online: The cost-effectiveness profile of sex-neutral HPV immunisation in European tender-based settings: a model-based assessment.

    Qendri, Venetia / Bogaards, Johannes A / Baussano, Iacopo / Lazzarato, Fulvio / Vänskä, Simopekka / Berkhof, Johannes

    The Lancet. Public health

    2020  Volume 5, Issue 11, Page(s) e592–e603

    Abstract: Background: In many European countries, human papillomavirus (HPV) vaccine uptake among girls has remained below target levels, supporting the scope for vaccination of boys. We aimed to investigate if sex-neutral HPV vaccination can be considered cost- ... ...

    Abstract Background: In many European countries, human papillomavirus (HPV) vaccine uptake among girls has remained below target levels, supporting the scope for vaccination of boys. We aimed to investigate if sex-neutral HPV vaccination can be considered cost-effective compared with girls-only vaccination at uptake levels equal to those among girls and under tender-based vaccination costs achieved throughout Europe.
    Methods: We investigated the cost-effectiveness of sex-neutral HPV vaccination in European tender-based settings. We applied a Bayesian synthesis framework for health economic evaluation to 11 countries (Austria, Belgium, Croatia, Estonia, Italy, Latvia, the Netherlands, Poland, Slovenia, Spain, and Sweden), accommodating country-specific information on key epidemiological and economic parameters, and on current HPV vaccination programmes. We used projections from three independently developed HPV transmission models to tailor region-specific herd effects. The main outcome measures in the comparison of sex-neutral with girls-only vaccination were cancer cases prevented and incremental cost-effectiveness ratios (ICERs), defined as the cost in international dollars (I$) per life-year gained.
    Findings: The total number of cancer cases to be prevented by vaccinating girls at currently realised vaccine uptake varied from 318 (95% CI 197-405) per cohort of 200 000 preadolescents (100 000 girls plus 100 000 boys) in Croatia (under 20% uptake of the 9-valent vaccine) to 1904 (1741-2101) in Estonia (under 70% uptake of the 9-valent vaccine). Vaccinating boys at equal coverage increased these respective numbers by 168 (95% CI 121-213) in Croatia and 467 (391-587) in Estonia. Sex-neutral vaccination was likely to be cost-effective, with ICERs of sex-neutral compared with girls-only vaccination varying from I$4300 per life-year gained in Latvia (95% credibility interval 3450-5160; 40% uptake) to I$25 720 per life-year gained in Spain (21 380-30 330; 80% uptake). At uniform 80% uptake, a favourable cost-effectiveness profile was retained for most of the countries investigated (Austria, Belgium, Italy, Latvia, the Netherlands, Slovenia, Spain, and Sweden).
    Interpretation: Sex-neutral HPV vaccination is economically attractive in European tender-based settings. However, tendering mechanisms need to ensure that vaccination of boys will remain cost-effective at high vaccine uptake rates.
    Funding: European Commission 7th Framework Programme and WHO.
    MeSH term(s) Bayes Theorem ; Cost-Benefit Analysis/economics ; Cost-Benefit Analysis/methods ; Cost-Benefit Analysis/statistics & numerical data ; Europe ; Female ; Humans ; Male ; Middle Aged ; Models, Economic ; Papillomavirus Infections/economics ; Papillomavirus Infections/prevention & control ; Papillomavirus Vaccines/economics ; Papillomavirus Vaccines/therapeutic use ; Uterine Cervical Neoplasms/economics ; Uterine Cervical Neoplasms/prevention & control
    Chemical Substances Papillomavirus Vaccines
    Language English
    Publishing date 2020-10-30
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2468-2667
    ISSN (online) 2468-2667
    DOI 10.1016/S2468-2667(20)30209-7
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  9. Article ; Online: Elimination of HPV-associated oropharyngeal cancers in Nordic countries.

    Lehtinen, Tuomas / Elfström, K Miriam / Mäkitie, Antti / Nygård, Mari / Vänskä, Simopekka / Pawlita, Michael / Dillner, Joakim / Waterboer, Tim / Lehtinen, Matti

    Preventive medicine

    2021  Volume 144, Page(s) 106445

    Abstract: Incidence of human papillomavirus (HPV, most notably HPV type 16) associated oropharyngeal squamous cell carcinoma (OPSCC) among middle-aged (50-69 year-old) males has tripled in four high income Nordic countries (Denmark, Finland, Norway and Sweden) ... ...

    Abstract Incidence of human papillomavirus (HPV, most notably HPV type 16) associated oropharyngeal squamous cell carcinoma (OPSCC) among middle-aged (50-69 year-old) males has tripled in four high income Nordic countries (Denmark, Finland, Norway and Sweden) over the last 30 years. In Finland and Sweden, this increase was preceded by an HPV16 epidemic in fertile-aged populations in the 1980's. The recent implementation of school-based prophylactic HPV vaccination in early adolescent boys and girls will gradually decrease the incidence, and eventually eliminate the HPV-associated OPSCCs (especially tonsillar and base of tongue carcinomas) in the Nordic countries. However, beyond the adolescent and young adult birth cohorts vaccinated, there are approximately 50 birth cohorts (born in 1995 or before) that would benefit from screening for HPV-associated OPSCC. This article reviews the need, prerequisites, proof-of-concept trial and prospects of preventing HPV-associated OPSCC in the Nordic countries.
    MeSH term(s) Adolescent ; Adult ; Aged ; Female ; Finland/epidemiology ; Humans ; Male ; Middle Aged ; Norway ; Oropharyngeal Neoplasms/epidemiology ; Oropharyngeal Neoplasms/prevention & control ; Papillomavirus Infections/epidemiology ; Papillomavirus Infections/prevention & control ; Scandinavian and Nordic Countries/epidemiology ; Sweden
    Language English
    Publishing date 2021-03-04
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 184600-0
    ISSN 1096-0260 ; 0091-7435
    ISSN (online) 1096-0260
    ISSN 0091-7435
    DOI 10.1016/j.ypmed.2021.106445
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  10. Article ; Online: Fast approximate computation of cervical cancer screening outcomes by a deterministic multiple-type HPV progression model.

    Vänskä, Simopekka / Bogaards, Johannes A / Auranen, Kari / Lehtinen, Matti / Berkhof, Johannes

    Mathematical biosciences

    2019  Volume 309, Page(s) 92–106

    Abstract: Cervical cancer arises differentially from infections with up to 14 high-risk human papillomavirus (HPV) types, making model-based evaluations of cervical cancer screening strategies computationally heavy and structurally complex. Thus, with the high ... ...

    Abstract Cervical cancer arises differentially from infections with up to 14 high-risk human papillomavirus (HPV) types, making model-based evaluations of cervical cancer screening strategies computationally heavy and structurally complex. Thus, with the high number of HPV types, microsimulation is typically used to investigate cervical cancer screening strategies. We developed a feasible deterministic model that integrates varying natural history of cervical cancer by the different high-risk HPV types with compressed mixture representations of the screened population, allowing for fast computation of screening interventions. To evaluate the method, we built a corresponding microsimulation model. The outcomes of the deterministic model were stable over different levels of compression and agreed with the microsimulation model for all disease states, screening outcomes, and levels of cancer incidence. The compression reduced the computation time more than 1000 fold when compared to microsimulation in a cohort of 1 million women. The compressed mixture representations enable the assessment of uncertainties surrounding the natural history of cervical cancer and screening decisions in a computationally undemanding way.
    MeSH term(s) Disease Progression ; Early Detection of Cancer ; Female ; Humans ; Models, Biological ; Papillomaviridae ; Papillomavirus Infections/diagnosis ; Uterine Cervical Neoplasms/diagnosis
    Language English
    Publishing date 2019-01-16
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 1126-5
    ISSN 1879-3134 ; 0025-5564
    ISSN (online) 1879-3134
    ISSN 0025-5564
    DOI 10.1016/j.mbs.2019.01.006
    Database MEDical Literature Analysis and Retrieval System OnLINE

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