Is Cervix Cancer a Disappearing Disease? Impact of HPV Vaccination in Developed Countries

Background: This commentary discusses key issues for health economic evaluation and modelling, applied to human papillomavirus (HPV) vaccine programs. Methods: We outline some of the specific features of HPV disease and vaccination, and associated policy questions in light of a literature search for economic evaluations on HPV vaccination. Results: We observe that some policy questions could not be reliably addressed by many of the 43 published economic evaluations we found. Despite this, policy making on universal HPV vaccination followed shortly after vaccine licensure in many developed countries, so the role economic evaluation played in informing these decisions (pre-dating 2008) seems to have been fairly limited. For more recent decisions, however, economic evaluation is likely to have been used more widely and more intensively. Conclusions: We expect future cost-effectiveness analyses to be more instrumental in policy making regarding vaccines covering more HPV types, therapeutic HPV vaccines, and novel diagnostic tests for biomarkers of HPV infection and disease integrated with cervical screening programs.

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HPV vaccine: uptake and understanding among global Indigenous communities – a qualitative systematic review

BMC Public Health ◽

10.1186/s12889-021-12147-z ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Brianna Poirier ◽

Sneha Sethi ◽

Gail Garvey ◽

Joanne Hedges ◽

Karen Canfell ◽

...

Keyword(s):

Systematic Review ◽

Indigenous Peoples ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Indigenous Communities ◽

Developed Countries ◽

Healthcare Research ◽

Vaccine Uptake ◽

Indigenous Populations ◽

Qualitative Systematic Review

Abstract Background Indigenous populations have a high prevalence of Human Papillomavirus (HPV) infection and a high incidence of HPV associated cancers, such as cervical and oropharyngeal cancer. There is an effective HPV vaccination program in almost all developed countries to prevent the incidence of cervical cancer, but reports suggest that the uptake of these vaccinations by Indigenous populations is low. The objective of this qualitative systematic review was to explore the knowledge and beliefs of global Indigenous populations regarding HPV vaccines. This review was performed to identify the barriers faced by Indigenous peoples and to provide evidence for more effective and acceptable execution of vaccination policies for Indigenous peoples. Methods Two investigators independently searched MEDLINE, PubMed, SCOPUS, and Web of Science databases using a pre-specified search strategy to identify qualitative studies on narratives of Indigenous peoples regarding HPV vaccine awareness, knowledge and experiences across all geographic and income-level settings. Results After performing the literature search and quality appraisals 5 papers were included in the final review. Three core synthesised findings were identified: reasons for acceptance or hesitancy, and areas for improvement. Lack of correct knowledge and mistrust in the healthcare system were important categories observed in all papers included in the review. Other categories within the conceptual model included prioritising disease prevention, health professional guidance, family support and supportive community environment. Conclusion Qualitative systematic reviews are an excellent means of exploring the gaps in current healthcare practices. Indigenous healthcare research should be grounded in community experiences and feedback. This review provides insights into HPV vaccination understanding and acceptance amongst Indigenous populations, from which recommendations for increasing resonance of vaccination strategies with Indigenous communities can be formed.

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HUBUNGAN PENGETAHUAN REMAJA PUTRI TENTANG VAKSINASI HPV DENGAN SIKAP DALAM PENCEGAHAN KANKER SERVIKS DI SMA NEGERI I DENPASAR TAHUN 2018

Jurnal Genta Kebidanan ◽

10.36049/jgk.v8i2.139 ◽

2018 ◽

Vol 8 (2) ◽

pp. 59

Author(s):

Ni Wayan Noviani ◽

Kadek Sintya Dewi

Keyword(s):

Human Papilloma Virus ◽

Hpv Vaccination ◽

Research Result ◽

Sampling Technique ◽

Simple Random Sampling ◽

Cervix Cancer ◽

Cross Sectional ◽

Papilloma Virus ◽

Probability Sampling ◽

Female Adolescence

Abstract : The Correlation Of Female Adolescence’s Knowledge About HPV Vaccination With Attitude In Prevention Of Cervix Cancer.This research has purpose to find out the Correlation of Female Adolescence Knowledge about HPV (Human Papilloma Virus) Vaccinatiion with Attitude in Prevention of Cervix Cancer carried out at SMA Negeri 1 denpasar on the date of 6th january 2018 during one day. Research type used in this research is analytic by using cross sectional approach that is by collecting variable of every object that is done only once. This research uses the probability sampling method by probability sampling technique. Sample in this research are the female students of Grade XI at SMA Negeri 1 Denpasar for 71 respondents. Research result shows that it is obtained that mostly which is for 42 respondents (59.2%) have good knowledge and mostly for 56 respondents (78.9%) have good attitude or positive. Therefore, there is significant correlation with strong correlation rate between the female adolescence’s knowledge about HPV vaccination and attitude in cervix cancer prevention. The correlation coefficient value is 0.644 with probability p = 0.001<0.05. Abstrak : Hubungan Pengetahuan Remaja Putri Tentang Vaksinasi HPV Dengan Sikap Dalam Pencegahan Kanker Serviks. Penelitian ini bertujuan untuk mengetahui Hubungan Pengetahuan Remaja Putri tentang Vaksinasi HPV (Human Papilloma Virus) dengan Sikap dalam Pencegahan Kanker Serviks yang dilaksanakan di SMA Negeri 1 Denpasar pada tanggal 6 Januari 2018 selama satu hari. Jenis penelitian yang digunakan dalam penelitian ini adalah analitik dengan menggunakan pendekatan cross sectionalyaitu pengumpulan variabel setiap objek dilakukan satu kali saja. Penelitian ini menggunakan metode probability samplingdengan teknik simple random sampling. Sampel dalam penelitian ini adalah siswi kelas XI di SMA Negeri 1 Denpasar sejumlah 71 responden. Hasil penelitian menunjukkan bahwa didapatkan sebagian besar yaitu sebanyak 42 responden (59,2%) memiliki pengetahuan baik dan sebagian besar sebanyak 56 responden (78,9%) memiliki sikap baik atau positif. Sehingga ada hubungan signifikan dengan tingkat korelasi kuat antara pengetahuan remaja putri tentang vaksinasi HPV dengan sikap dalam pencegahan kanker serviks. Nilai koefisien korelasinya sebesar 0,644 dengan nilai probabilitasnya sebesar p = 0,001<0,05. Kata Kunci:Pengetahuan, Remaja Putri, Vaksinasi HPV, Sikap, Kanker Serviks

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Development of a quality framework for models of cervical screening and its application to evaluations of the cost-effectiveness of HPV vaccination in developed countries

Vaccine ◽

10.1016/j.vaccine.2014.08.048 ◽

2015 ◽

Vol 33 (1) ◽

pp. 34-51 ◽

Cited By ~ 6

Author(s):

Leonardo Simonella ◽

Karen Canfell

Keyword(s):

Cost Effectiveness ◽

Cervical Screening ◽

Hpv Vaccination ◽

Developed Countries ◽

Quality Framework ◽

The Cost

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Knowledge of cervix cancer, human papilloma virus (HPV) and HPV vaccination at the moment of introduction of the vaccine in women in Belgium

Archives of Gynecology and Obstetrics ◽

10.1007/s00404-007-0487-1 ◽

2007 ◽

Vol 277 (4) ◽

pp. 291-298 ◽

Cited By ~ 37

Author(s):

Gilbert G. G. Donders ◽

Maria Gabrovska ◽

Gert Bellen ◽

Joachim Van Keirsbilck ◽

Thierry Van Den Bosch ◽

...

Keyword(s):

Human Papilloma Virus ◽

Hpv Vaccination ◽

Cervix Cancer ◽

Papilloma Virus ◽

The Moment

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CERVICAL CANCER AND OTHER HPV ASSOCIATED TUMORS IN RUSSIA

Problems in oncology ◽

10.37469/0507-3758-2020-66-4-325-335 ◽

2020 ◽

Vol 66 (4) ◽

pp. 325-335

Author(s):

David Zaridze ◽

Dmitriy Maksimovich ◽

Ivan Stilidi

Keyword(s):

Cervical Cancer ◽

Hpv Vaccination ◽

Significant Proportion ◽

Developed Countries ◽

Screening Methods ◽

Hpv Testing ◽

Female Population ◽

Subsequent Decrease ◽

Incidence And Mortality ◽

Associated Tumors

The incidence of cervical cancer in Russia is one of the highest in Europe. At the same time, in European countries, the incidence of other HPV-associated tumors is as low as in Russia. The incidence of cervical cancer is declining in most countries of the world. Unfortunately, in our country, a decrease in the incidence and mortality from cervical cancer before the early 1990s was replaced by an increase in these rates. This trend will continue and reach fairly high numbers in 2030. The increase and subsequent decrease in the incidence and mortality of cervical cancer, which has been observed in developed countries for several decades, is largely the result of population cytological screening with coverage of 70-80% of the female population of the corresponding age. In our country cytological testing organized in the polyclinics, which covered a significant proportion of working women and which, as you know, has been introduced into healthcare practice since 1976, has led only to a temporary decrease in the incidence of cervical cancer. Unfortunately, in the late 1980s, this program ceased to exist and, consequently, a decrease in the incidence of cervical cancer was replaced by its growth. So called dispanserisation, which is presently in place, which includes cytological screening of cervical cancer, has not yet led to the expected results. Despite the fact that the goal of our article is not to evaluate the effectiveness of various screening methods, we consider it necessary to note that screening with HPV testing, which according to randomized trials, is much more effective than cytological examination is widely used in most countries, in combination with HPV vaccination. Prevention of cervical cancer includes: a) mandatory vaccination against HPV in adolescence (11-13 years); b) screening based on HPV testing.

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Human Papilloma Virus Vaccine for Cervical Cancer Prevention

Journal of Bangladesh College of Physicians and Surgeons ◽

10.3329/jbcps.v39i2.52392 ◽

2021 ◽

Vol 39 (2) ◽

pp. 123-131

Author(s):

Chowdhury Shamima Sultana

Keyword(s):

Public Health ◽

Cervical Cancer ◽

Screening Program ◽

Hpv Vaccination ◽

Invasive Cervical Cancer ◽

Public Health Problem ◽

Developed Countries ◽

Hpv Infection ◽

Human Papilloma Virus Vaccine ◽

Major Public Health Problem

HPV infection is estimated to be responsible for about 5% of human cancers worldwide. Among all HPV-associated malignancies, cervical cancer is the most important cause of morbidity and mortality worldwide. Cervical cancer is the fourth most common cancer in women worldwide and leading cause of cancer death among females in less developed countries. Persistent HPV infection is a necessary cause of invasive cervical cancer with a prevalence of 99.7% in cervical cancer worldwide.At least 70% of cervical cancers are caused by HPV 16 and HPV 18. HPV vaccination in combination with regular screening offers the most effective way for women to be protected against cervical cancer.The global burden of cervical cancer falls heaviest on the developing countries which haven’t introduced the HPV vaccine as part of their national public health strategy to prevent and control cervical cancer. Different studies showed a drop in the prevalence of HPV associated diseases in vaccinated populations. Sustained efficacy, immunogenicity, and safety of the bHPV vaccine were observed in the final analysis of a follow-up study up to 9.4 years postvaccination. Cervical cancer is a major public health problem in Bangladesh. There has been little success with screening program against cervical cancer in Bangladesh. Therefore, a National HPV Vaccination Program seems to be the window of opportunity to reduce the mortality and morbidity of cervical cancer in Bangladesh. J Bangladesh Coll Phys Surg 2021; 39(2): 123-131

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Pembrolizumab in cervical cancer: latest evidence and clinical usefulness

Therapeutic Advances in Medical Oncology ◽

10.1177/1758834017708742 ◽

2017 ◽

Vol 9 (6) ◽

pp. 431-439 ◽

Cited By ~ 35

Author(s):

Edith Borcoman ◽

Christophe Le Tourneau

Keyword(s):

Cervical Cancer ◽

Checkpoint Inhibitors ◽

Early Stage ◽

Precancerous Lesions ◽

Treatment Options ◽

Hpv Vaccination ◽

Developed Countries ◽

Clinical Usefulness ◽

Early Stage Cervical Cancer ◽

Tumor Types

Cervical cancer is the fourth most common cause of cancer-related deaths in women worldwide. With the development of detection of precancerous lesions and preventive human papillomavirus (HPV) vaccination program, a survival improvement has been observed in these patients in developed countries, although disparities in accessibility to treatments exist across countries. While early-stage cervical cancer can be curable with surgery, prognosis of patients who recur remains poor, with limited treatment options. In this latter setting, recently, bevacizumab, an antiangiogenic monoclonal antibody targeting vascular endothelial growth factor (VEGF), has been shown to improve overall survival in combination with chemotherapy as compared with chemotherapy alone. No standard treatments exist beyond this treatment regimen. New effective treatments are therefore much needed in this setting. Immunotherapy has represented a breakthrough in recent years in oncology, with antitumor activity reported with immune-checkpoint inhibitors in a variety of tumor types. We discuss here the latest evidence and clinical usefulness of pembrolizumab, anti-PD-1 checkpoint inhibitor, in the treatment of advanced cervical cancer.

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Developed Countries Vaccinate, Brazil Denies: Popular Action for HPV Vaccination. Is Judicialization of Health Valid?

Jornal Brasileiro de Doenças Sexualmente Transmissíveis ◽

10.5533/2177-8264-201224104 ◽

2012 ◽

Vol 24 (1) ◽

pp. 7-8

Author(s):

Mauro Romero Passos

Keyword(s):

Hpv Vaccination ◽

Developed Countries ◽

Judicialization Of Health

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A preliminary cost-effectiveness analysis of human papillomavirus vaccination in males for the prevention of oropharyngeal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.6033 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 6033-6033 ◽

Cited By ~ 1

Author(s):

Donna M. Graham ◽

Wanrudee Isaranuwatchai ◽

Steven Habbous ◽

Claire de Oliveira ◽

Geoffrey Liu ◽

...

Keyword(s):

Human Papillomavirus ◽

Cost Effectiveness ◽

Vaccine Efficacy ◽

Oropharyngeal Cancer ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Cost Effectiveness Analysis ◽

Cervix Cancer ◽

Vaccine Uptake ◽

Effectiveness Analysis

6033 Background: Many western countries have established female human papillomavirus (HPV) vaccination programmes for prevention of cervix cancer. Efficacy against additional HPV-related disease is proven in both sexes, but cost-effectiveness of male vaccination remains controversial. Projected figures suggest incidence and prevalence of oropharyngeal cancer (OPC) in North America will exceed that of cervix cancer by 2020 due to HPV-related cases. Two cost-effectiveness analyses evaluating male HPV vaccination have included OPC, with contrasting results. The Canadian government recommends, but does not fund, male vaccination. In order to assess the value for money of male HPV vaccination in Canada with respect to OPC, we performed a preliminary cost-effectiveness analysis. Methods: Following extensive literature review regarding HPV-related OPC in Canadian males, healthcare cost and clinical effectiveness estimates were obtained from published studies. A Markov model was used to compare potential costs and effectiveness of HPV vaccination against no vaccination among males aged 12 years old. A 3-month cycle length was used with a ‘lifetime’ time horizon. The outcome of the analysis was the incremental cost per quality-adjusted life-year (QALY). Sensitivity analyses were conducted on variables such as vaccine uptake rate and efficacy. Results: Assuming 99% vaccine efficacy and 70% uptake, the use of HPV vaccine produced 0.05 more QALYs and saved $204 Canadian dollars (CAD) per person compared with no vaccine (QALYs and costs discounted at 5% per year). Assuming 50% vaccine efficacy and 50% uptake, use of HPV vaccine produced 0.01 more QALYs and saved $43 CAD. Based on a population of 12 year old males of 192,940 in 2012, male HPV vaccination may potentially save $8.3-39.4 million CAD for this cohort over its lifetime. Conclusions: Knowledge gaps exist regarding male HPV vaccination for OPC prevention. Due to practical limitations, including lack of identifiable precursor lesions in OPC, clinical trials to evaluate this issue may not be feasible. Without considering the effects of herd immunity, this preliminary analysis highlights potential savings from male vaccination.

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