WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention: use of human papillomavirus (HPV) DNA genotyping: web annex B: evidence-to-decision tables
Overview
Cervical cancer remains a major public health challenge, particularly in settings with limited access to effective screening and follow-up services. This document forms part of the evidence base underpinning WHO recommendations on the use of human papillomavirus (HPV) DNA genotyping for the prevention of cervical cancer. It presents structured evidence-to-decision (EtD) tables that synthesize data on the benefits and harms of different HPV screening strategies, including no genotyping, limited genotyping and extended genotyping, across varying levels of programme capacity.
The annex applies the EtD framework to assess key domains such as desirable and undesirable effects, certainty of evidence, values, resource use, cost–effectiveness, equity, acceptability and feasibility. It integrates findings from genotype-specific risk analyses and modelling of screening outcomes under different follow-up scenarios. The document highlights how the balance of effects varies according to health system capacity and clarifies the rationale for context-specific, conditional recommendations based on low-certainty evidence. It is intended to support policymakers, programme managers and technical experts in interpreting the guideline and selecting appropriate screening and treatment approaches within cervical cancer prevention programmes.
