Table 1 PARAMETER[S] estimates and sources

Prevalence rate

38.8

[1]

Crude Incidence rate/100000

16.5

[1]

Year 2009

Number of deaths

2100

[1]

Number of cases

4178

[1]

No diagnosed with cervical cancer each year

2635

[1]

2011 life expectancy in Kenya

60.7

Average age of onset of cervical cancer

45 Years

Baseline survey

Average duration of cervical cancer

7.5years

Experts opinion

DALY assumptions for cancer

Age of onset of death or disability in years [a]

40.

Baseline survey

Disability weight [D]

0.81

Percent of surviving cases with sequelae

0%

Expert opinion

Assumed all eventually will die from Ca Cervix

Mortality to incidence ratio

.55

[1]

Mortality from other causes not directly connected to Cancer of Cervix

0.008

Experts opinion

This was considered insignificant hence not modeled.

Crude mortality rate

13.2

[2]

Age-standardized mortality rate

23.4

[2]

Screening coverage rate within 3 years

3.2

[2]

Rate of primary vaccination

0.01

Experts opinion

Limited data available

Rate of secondary vaccination

0.03

Experts opinion

Limited data available

No of primary vaccinations required to avert one case of Ca cervix

250

[3]

Assuming a life time protection

No of primary vaccinations required to avert one case of Ca cervix

600

[3]

Assuming waning off of vaccine protection after 10 years.

No of secondary/catch up vaccinations required to avert one case of Ca cervix

324

[3].

E-health usage

Percentage with access to internet

7.5

Baseline survey

Percentage with access to mobile phone

96

Baseline survey

Percentage with positive attitude towards use of e-health

95

Baseline survey

PROGNOSIS OF undiagnosed Ca. cervix

Percentage of death from invasive cancer

33

[4]

time span between infection of HPV and development of carcinoma in Situ

7 to 15 years

[5]

Years taken by precancerous cells to progress to cancerous cells

5

[5]

Percentage of progress from precancerous stage to undiagnosed stage one

3 – 10%

[5] [4]

Percentage of regression from precancerous stage to ‘clean’ state through immune reaction

90-97%

[4–6]

Progression of undiagnosed cancer from stage 2 to Stage 3

40%

[6]

Progression of Undiagnosed cancer from stage 3 to stage 4

80%

[6]

PROGNOSIS OF diagnosed Ca. cervix

Treatment impact/five year survival rate

Early intervention survival rate

92%

[6]

.277

Stage 1 survival rate

90%

[6]

.271

Stage 2 survival rate

60-80%

[6]

Average 70% used in this model

.211

Stage 3 survival rate

50%

[6]

.151

Stage 4 survival rate

Less than 30%

[6]

30% used in this model .091