Prevention of cervical cancer in rural China: Evaluation of HPV vaccination and primary HPV screening strategies
| Autor: | Megan Smith, Jie-Bin Lew, Karen Canfell, Rosa Legood, Jufang Shi, Leonardo Simonella, Robert Walker, Jun-Feng Chen, You-Lin Qiao, Carolyn Nickson, Fang-Hui Zhao |
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| Rok vydání: | 2011 |
| Předmět: |
Adult
Rural Population China Pediatrics medicine.medical_specialty Adolescent Cost effectiveness Cost-Benefit Analysis Population Uterine Cervical Neoplasms Young Adult Virology Humans Mass Screening Medicine Papillomavirus Vaccines Papillomaviridae Young adult Child education Mass screening Aged Aged 80 and over Gynecology Cervical cancer education.field_of_study Models Statistical Cervical screening General Veterinary General Immunology and Microbiology biology business.industry Public Health Environmental and Occupational Health Middle Aged biology.organism_classification medicine.disease Vaccination Infectious Diseases Molecular Medicine Female business |
| Zdroj: | Vaccine. 29:2487-2494 |
| ISSN: | 0264-410X |
| DOI: | 10.1016/j.vaccine.2010.12.085 |
| Popis: | Comprehensive evaluation of the cost-effectiveness of HPV vaccination in China has not previously been performed. The objective of this study was to evaluate vaccination as an alternative or addition to primary HPV screening with careHPV (Qiagen, Gaithersburg, USA), and to assess the threshold total cost per vaccinated girl (CVG) at which strategies involving vaccination would become viable compared to screening-only strategies in rural China. We used data from field studies in Shanxi Province to support modelling of HPV vaccination and screening, including local information on sexual behaviour, HPV prevalence, test accuracy, treatment protocols and costs. We evaluated several strategies involving screening once or twice per lifetime or at regular 5-yearly intervals, with or without vaccination of young females at age 15 years, assuming 70% coverage for both screening and vaccination. We also predicted cross-sectional cancer incidence each year to the year 2050 for a range of strategies. We found that strategies involving vaccination would be cost-effective at CVGs of US$50-54 or less, but at CVGs >$54, screening-only strategies would be more cost-effective. If vaccination of young cohorts is combined with two rounds of careHPV screening for women aged 30-59 years in 2012 and 2027, a predicted indicative 33% reduction in cervical cancer incidence by 2030 would be sustained until 2050, with incidence rates decreasing thereafter. In conclusion, taking into account estimated vaccine delivery costs (for 3 doses), a per-dose HPV vaccine cost of approximately |
| Databáze: | OpenAIRE |
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