Cost-Effectiveness of HPV-Vaccination in Medium or Low Income Countries with High Cervical Cancer Incidence – A Systematic Review

Background Though cervical cancer is one of the leading causes of death globally, its incidence is nearly entirely preventable. Young people have been an international priority for screening. However, in both high-income and low-income countries, young people have not been screened appropriately according to country-specific guidelines and in many countries, screening rates for this age-group have even dropped. Objectives The aim of this systematic review was to systematically characterize the existing literature on barriers and facilitators for cervical cancer screening among young people globally. Search Strategy We conducted a systematic review following PRISMA guidelines of four databases: Medline-OVID, EMBASE, CINAHL, and ClinicalTrials.Gov. Selection Criteria We only examined original, peer-reviewed literature. Databases were examined from inception until the date of our literature searches (12/03/2020). Articles were excluded if they did not specifically discuss cervical cancer screening, were not specific to young people, or did not report outcomes or evaluation. Data Collection and Analysis All screening and extraction was completed in duplicate with two independent reviewers. Main Results Of the 2177 original database citations, we included 36 studies that met inclusion criteria. Our systematic review found that there are three large categories of barriers for young people: lack of knowledge/awareness, negative perceptions of the test, and practical barriers to testing. Facilitators included stronger relationships with healthcare providers, social norms, support from family, and self-efficacy. Conclusions Health systems worldwide should address the barriers and facilitators to increase cervical cancer screening rates in young people. Further research is required to understand this age group.

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A Systematic Review of Cervical Cancer Incidence and Mortality in the Pacific Region

Asian Pacific Journal of Cancer Prevention ◽

10.7314/apjcp.2014.15.21.9433 ◽

2014 ◽

Vol 15 (21) ◽

pp. 9433-9437 ◽

Cited By ~ 14

Author(s):

J. Obel ◽

Y. Souares ◽

D. Hoy ◽

W. Baravilala ◽

S.M. Garland ◽

...

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Cancer Incidence ◽

Pacific Region ◽

Cervical Cancer Incidence ◽

The Pacific ◽

Incidence And Mortality

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Cervical cancer incidence can increase despite HPV vaccination

The Lancet Infectious Diseases ◽

10.1016/s1473-3099(10)70182-1 ◽

2010 ◽

Vol 10 (9) ◽

pp. 594-595 ◽

Cited By ~ 23

Author(s):

Diane M Harper ◽

Pekka Nieminen ◽

Jorma Paavonen ◽

Matti Lehtinen

Keyword(s):

Cervical Cancer ◽

Cancer Incidence ◽

Hpv Vaccination ◽

Cervical Cancer Incidence

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Mapping evidence on management of cervical cancer in sub-Saharan Africa: scoping review protocol

Systematic Reviews ◽

10.1186/s13643-021-01740-3 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Petmore Zibako ◽

Mbuzeleni Hlongwa ◽

Nomsa Tsikai ◽

Sarah Manyame ◽

Themba G. Ginindza

Keyword(s):

Systematic Review ◽

Cervical Cancer ◽

Scoping Review ◽

Low Income ◽

Sub Saharan Africa ◽

Low Income Countries ◽

Attitudes And Practices ◽

Cancer Management ◽

Scoping Reviews ◽

Sub Saharan

Abstract Background Cancer is a non-communicable disease and is the number 2 leading cause of death globally. Among all cancers, cervical cancer is the number 1 killer of women in low-income countries (LICs). Cervical cancer is a well understood preventable cancer. The rates of cervical cancer are very varied and inversely proportional to the effectiveness of disease management policies. Management of cervical cancer includes prevention, screening, diagnosis and treatment. The main objective of this scoping review is to map the evidence on cervical cancer management in sub-Saharan Africa (SSA) to understand the coverage of cervical cancer prevention and treatment services and provide an opportunity to generate knowledge on the risk factors, attitudes and practices extendable globally. Methods and analysis This review will be guided by Arksey and O’Malley’s framework recommended for conducting scoping review studies. The Preferred Reporting Items for Systematic Review and Meta-Analysis extension for Scoping Reviews (PRISMA-Scr) checklist will also be completed to ensure that the review adheres to the sound methodological rigour acceptable for scoping review studies. The following electronic databases will be searched for potentially eligible articles: PubMed, Ebsco Host, Scopus and Cochrane Database of Systematic Reviews. Study screening procedures recommended by Higgins and Deeks will be followed. A narrative synthesis will be used, with data synthesised and interpreted using sifting, charting and sorting based on themes and key issues. Discussion Cervical cancer can become a disease of the past with a proper control strategy in place. It is therefore imperative to map available evidence on the management of cervical cancer to inform policy and advocacy action. More knowledge on the status quo will guide policymakers in ensuring cancer management guiding policies are formulated/updated/revised accordingly. Systematic review registration Not registered with PROSPERO (not needed). Protocol and registration This scoping review was not registered.

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Potential for cervical cancer incidence and death resulting from Japan’s current policy of prolonged suspension of its governmental recommendation of the HPV vaccine

Scientific Reports ◽

10.1038/s41598-020-73106-z ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Asami Yagi ◽

Yutaka Ueda ◽

Satoshi Nakagawa ◽

Sayaka Ikeda ◽

Yusuke Tanaka ◽

...

Keyword(s):

Cervical Cancer ◽

Cancer Incidence ◽

Hpv Vaccine ◽

Hpv Vaccination ◽

Policy Decision ◽

Daily Basis ◽

Vaccination Rate ◽

Cervical Cancer Incidence ◽

Temporary Suspension ◽

The Government

Abstract In 2013, recurrent reports of diverse symptoms occurring in girls after receiving HPV vaccination appeared in Japanese media. The Ministry of Health, Labor and Welfare quickly responded by announcing a temporary suspension of its recommendation for the vaccine. The HPV vaccination rate soon fell to almost zero. In the present study, we calculated the potential future numbers of cervical cancer incidence and death that will be increased by this policy decision. We have assumed that the number of yearly vaccinations is evenly distributed across a daily basis. Future incidence and death increased in females born in FY2000 are estimated to be 3651 and 904, respectively, 4566 and 1130 for those born in FY2001, 4645 and 1150 for those born in FY2002, and 4657 and 1153 for those born in FY2003. In FY2020, the large increase of risks to females born in FY2004 amounts to 12.0 females per day who will now be at a higher risk for acquiring of cervical cancer in their future, and 3.0 females per day newly at risk for future death from that disease in its progressive form. No one should be able to accept this situation. We sincerely ask the government to resume its recommendation for the vaccine as soon as possible.

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Impact of screening on cervical cancer incidence in England: a time trend analysis

BMJ Open ◽

10.1136/bmjopen-2018-026292 ◽

2019 ◽

Vol 9 (1) ◽

pp. e026292 ◽

Cited By ~ 3

Author(s):

Francesca Pesola ◽

Peter Sasieni

Keyword(s):

Cervical Cancer ◽

Trend Analysis ◽

Cancer Incidence ◽

Cervical Screening ◽

Hpv Vaccination ◽

Cervical Cancer Incidence ◽

Incidence Data ◽

Cancer Registry Data ◽

Current Scenario ◽

The Impact

ObjectivesTo better model underlying trends in cervical cancer incidence so as to model past trends, to estimate the impact of cervical screening on cervical cancer rates at different ages and to obtain a counterfactual baseline under a no-screening scenario.DesignTrend analysis of cancer registry data recorded between 1971 and 2013.SettingEngland.Participants132 493 women aged 20–84 with a diagnosis of cervical cancer.Outcome measureCervical cancer incidence data were modelled using a modified age period cohort model able to capture both increased exposure to human papillomavirus (HPV) as well as changes in the age of exposure to HPV in young cohorts. Observed rates were compared with counterfactual baseline rates under a no-screening scenario to estimate the protective effect of screening.ResultsRates of cervical cancer incidence have been decreasing since the introduction of screening but are projected to increase in the future under the current scenario. Between 1988 and 2013, it was estimated that screening had prevented approximately 65 000 cancers. Moreover, in 2013, the age-standardised rate (ASR) estimated under the no-screening scenario (37.9, 95% CI 37.4 to 38.3) was threefold higher among women aged 20–84 than the observed ASR (12.8, 95% CI 12.3 to 13.3). We estimate that the age of first HPV exposure has decreased by about 1 year every decade since the early 1970s (women born in 1955 onwards).ConclusionsOur results corroborated the importance of screening in preventing cervical cancer and indicated future rates are dependent on age at HPV exposure. Estimated future rates can be used for healthcare planning while the counterfactual baseline to quantify the impact of HPV vaccination in microsimulations.

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