Temporary Removal: From cervical cancer elimination to eradication of vaccine-type human papillomavirus: Feasibility, public health strategies and cost-effectiveness

Background: The cost-effectiveness of adding a human papillomavirus (HPV) vaccine to the Australian National Cervical Screening Program compared to screening alone was examined. Methods: A Markov model of the natural history of HPV infection that incorporates screening and vaccination was developed. A vaccine that prevents 100% of HPV 16/18-associated disease, with a lifetime duration of efficacy and 80% coverage offered through a school program to girls aged 12 years, in conjunction with current screening was compared with screening alone using cost (in Australian dollars) per life-year (LY) saved and quality-adjusted life-year (QALY) saved. Sensitivity analyses included determining the cost-effectiveness of offering a catch-up vaccination program to 14–26-year-olds and accounting for the benefits of herd immunity. Results: Vaccination with screening compared with screening alone was associated with an incremental cost-effectiveness ratio (ICER) of $51 103 per LY and $18 735 per QALY, assuming a cost per vaccine dose of $115. Results were sensitive to assumptions about the duration of vaccine efficacy, including the need for a booster ($68 158 per LY and $24 988 per QALY) to produce lifetime immunity. Accounting for herd immunity resulted in a more attractive ICER ($36 343 per LY and $13 316 per QALY) for girls only. The cost per LY of vaccinating boys and girls was $92 052 and the cost per QALY was $33 644. The cost per LY of implementing a catch-up vaccination program ranged from $45 652 ($16 727 per QALY) for extending vaccination to 14-year-olds to $78 702 ($34 536 per QALY) for 26-year-olds. Conclusions: These results suggest that adding an HPV vaccine to Australia’s current screening regimen is a potentially cost-effective way to reduce cervical cancer and the clinical interventions that are currently associated with its prevention via screening alone.

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Conocimiento y actitudes hacia el virus del papiloma humano en una población de universitarios españoles = Knowledge and attitudes towards human papillomavirus in a population of Spanish university students

REVISTA ESPAÑOLA DE COMUNICACIÓN EN SALUD ◽

10.20318/recs.2018.4248 ◽

2018 ◽

Vol 9 (1) ◽

pp. 14 ◽

Cited By ~ 1

Author(s):

Luz Martínez-Martínez ◽

Ubaldo Cuesta Cambra

Keyword(s):

Public Health ◽

Cervical Cancer ◽

Health Promotion ◽

Human Papillomavirus ◽

Young People ◽

University Students ◽

Preventive Healthcare ◽

Knowledge And Attitudes ◽

Prevention And Early Detection ◽

Vaccination Campaigns

Resumen: El virus del papiloma humano se relaciona con varios tipos de cáncer como el de cuello de útero (CCU), orofarínge, pene o ano. Más de 4.000 mujeres mueren al año por CCU en EEUU y más de 2.000 en España a pesar de la vacunación y aunque estos cánceres son prevenibles mediante la prevención y detección precoz. Por lo tanto, el conocimiento y comprensión del VPH son vitales para su prevención y normalización. Este trabajo evalúa el conocimiento de los jóvenes sobre el VPH, su actitud hacia las revisiones o a hablar de él. Se realizó un diseño descriptivo transversal con jóvenes universitarios. Los participantes mostraron un bajo conocimiento sobre el VPH, sobre su transmisión, detección y medidas preventivas. Muchos no saben que afecta a hombres o su relación con el CCU. No creen que las revisiones sean importantes y sienten vergüenza de hablar del VPH o de que sepan que lo padecen. Los datos muestran la necesidad de complementar las campañas de vacunación con intervenciones informativas y de comunicación sexual entre jóvenes y padres, la necesidad de campañas para la concienciación sobre las revisiones y comprensión de la enfermedad que ayuden a su normalización.Palabras clave: Virus Papiloma Humano; salud pública; prevención de enfermedades; jóvenes; enfermedades de transmisión sexual.Abstract: Human Papillomavirus is related to various types of cancer such as cervical cancer, oropharyngeal, penis and anus. More than 4.000 women died per year because of cervical cancer in EEUU and over 2.000 in Spain despite vaccination and although these cancers are preventable through prevention and early detection. Therefore, knowledge and understanding of HPV are vital for its prevention and its normalization. This work evaluates young people’s knowledge about HPV, their attitude toward reviews, or discusses HPV. A transversal descriptive design was carried out with university students. Young people showed low knowledge about HPV, its transmission, detection and preventive steps. Many do not knowits affection to men or their relationship with cervical cancer. Young people do not think the check-ups are important and they feel embarrassed about talking about HPV or if others know they are affected by it. Data shows the need to complement vaccination campaigns with informative and sexual commu nication interventions among young people and parents, and the need of campaigns for the awareness of the check-ups and the understanding of the disease to help to its normalization.Keywords: Human Papillomavirus; Public health; Preventive healthcare; Health promotion; Young people; sexual transmitted diseases.

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Cost-effectiveness of a bivalent human papillomavirus vaccination program in Japan

Sexual Health ◽

10.1071/sh14241 ◽

2015 ◽

Vol 12 (6) ◽

pp. 520 ◽

Cited By ~ 5

Author(s):

Luke B. Connelly ◽

Ha N. D. Le

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Screening Program ◽

Vaccine Coverage ◽

Precancerous Lesions ◽

Hpv Vaccination ◽

Vaccination Program ◽

Human Papillomavirus Vaccination ◽

The Cost

Background Human papillomavirus (HPV) vaccines and their widespread adoption have the potential to relieve a large part of the burden of cervical cancer morbidity and mortality, particularly in countries that have low screening rates or, like Japan, lack a cohesive universal screening program. An economic evaluation was conducted to assess the cost-effectiveness of introducing a bivalent HPV vaccination program in Japan from a healthcare perspective. Methods: A Markov model of the natural history of HPV infection that incorporates both vaccination and screening was developed for Japan. The modelled intervention, a bivalent HPV vaccine with a 100% lifetime vaccine efficacy and 80% vaccine coverage, given to a cohort of 12-year-old Japanese girls in conjunction with the current screening program, was compared with screening alone in terms of costs and effectiveness. A discount rate of 5% was applied to both costs and utilities where relevant. Results: Vaccination alongside screening compared with screening alone is associated with an incremental cost-effectiveness ratio (ICER) of US$20 315 per quality-adjusted-life-year gained if 80% coverage is assumed. The ICER at 5% coverage with the vaccine plus screening, compared with screening alone, is US$1158. Conclusion: The cost-effectiveness results suggest that the addition of a HPV vaccination program to Japan’s cervical cancer screening program is highly likely to prove a cost-effective way to reduce the burden of cervical cancer, precancerous lesions and HPV16/18-related diseases.

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Cost-effectiveness of HPV-based cervical cancer screening in the public health system in Nicaragua

BMJ Open ◽

10.1136/bmjopen-2016-015048 ◽

2017 ◽

Vol 7 (6) ◽

pp. e015048 ◽

Cited By ~ 7

Author(s):

Nicole G Campos ◽

Mercy Mvundura ◽

Jose Jeronimo ◽

Francesca Holme ◽

Elisabeth Vodicka ◽

...

Keyword(s):

Public Health ◽

Cervical Cancer ◽

Cost Effectiveness ◽

Cancer Screening ◽

Health System ◽

Cervical Cancer Screening ◽

Public Health System ◽

The Public

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Cost-Effectiveness of Human Papillomavirus Vaccination and Cervical Cancer Screening in Women Older Than 30 Years in the United States

Annals of Internal Medicine ◽

10.7326/0003-4819-151-8-200910200-00002 ◽

2009 ◽

Vol 151 (8) ◽

pp. I

Keyword(s):

United States ◽

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Cancer Screening ◽

Cervical Cancer Screening ◽

The United States ◽

Human Papillomavirus Vaccination

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Cost-effectiveness analysis of the introduction of a quadrivalent human papillomavirus vaccine in France

International Journal of Technology Assessment in Health Care ◽

10.1017/s0266462307080026 ◽

2008 ◽

Vol 24 (01) ◽

pp. 10-19 ◽

Cited By ~ 64

Author(s):

Christine Bergeron ◽

Nathalie Largeron ◽

Ruth McAllister ◽

Patrice Mathevet ◽

Vanessa Remy

Keyword(s):

Cervical Cancer ◽

Human Papillomavirus ◽

Cost Effectiveness ◽

Incremental Cost ◽

Hpv Vaccine ◽

Screening Program ◽

Sensitivity Analyses ◽

Quadrivalent Hpv Vaccine ◽

Hpv Types ◽

Current Screening

Objectives:A vaccine to prevent diseases due to human papillomavirus (HPV) types 6, 11, 16, and 18 is now available in France. The objective of this study was to assess the health and economic impact in France of implementing a quadrivalent HPV vaccine alongside existing screening practices versus screening alone.Methods:A Markov model of the natural history of HPV infection incorporating screening and vaccination, was adapted to the French context. A vaccine that would prevent 100 percent of HPV 6, 11, 16, and 18-associated diseases, with lifetime duration and 80 percent coverage, given to girls at age 14 in conjunction with current screening was compared with screening alone. Results were analyzed from both a direct healthcare cost perspective (DCP) and a third-party payer perspective (TPP). Indirect costs such as productivity loss were not taken into account in this analysis.Results:The incremental cost per life-year gained from vaccination was €12,429 (TPP) and €20,455 (DCP). The incremental cost per quality-adjusted life-year (QALY) for the introduction of HPV vaccination alongside the French cervical cancer screening program was €8,408 (TPP) and €13,809 (DCP). Sensitivity analyses demonstrated that cost-effectiveness was stable, but was most sensitive to the discount rate used for costs and benefits.Conclusions:Considering the commonly accepted threshold of €50,000 per QALY, these analyses support the fact that adding a quadrivalent HPV vaccine to the current screening program in France is a cost-effective strategy for reducing the burden of cervical cancer, precancerous lesions, and genital warts caused by HPV types 6, 11, 16, and 18.

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