Estimating the long-term impact of a prophylactic human papillomavirus 16/18 vaccine on the burden of cervical cancer in the UK

Kohli, Michele; Ferko, Nicole; Martin, Aurélie; Franco, Eduardo L.; Jenkins, David; Gallivan, S; Sherlaw-Johnson, C; Drummond, Michael

doi:10.1038/sj.bjc.6603501

Cited by 100 publications

(87 citation statements)

References 36 publications

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“…Our results differ from other studies that have shown more favorable effects (Goldie et al 2004;Barnabas and Garnett 2005;Elbasha et al 2007;French et al 2007;Insinga et al 2007;Kohli et al 2007;Dasbach et al 2008). This is firstly due to the different research question in our study, which addresses population-wide benefits for a given time period rather than health effects for vaccinated cohorts.…”

Section: Discussioncontrasting

confidence: 56%

“…They have been developed for several countries, often in combination with an economic evaluation (Kulasingam and Myers 2003;Sanders and Taira 2003;Goldie et al 2004Goldie et al , 2007Taira et al 2004;Barnabas and Garnett 2005;Garnett et al 2006;Brisson et al 2007;Elbasha et al 2007;French et al 2007;Insinga et al 2007;Kohli et al 2007 Thiry et al 2007;Bergeron et al 2008;Dasbach et al 2008;Jit et al 2008;Kim and Goldie 2008;Kulasingam et al 2008). However, for producing reliable results, countryspecific models are required that take into account countryspecific features such as screening policy, epidemiology of the disease under evaluation and HPV prevalence.…”

Section: Introductionmentioning

confidence: 99%

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HPV-vaccination for the prevention of cervical cancer in Austria: a model based long-term prognosis of cancer epidemiology

Zechmeister

Blasio

Garnett³

2009

J Public Health

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Aim Cervical cancer incidence and mortality have decreased for the last 20 years in Austria; however, they remain relatively high in comparison to other European countries. Screening quality has been suboptimal. In this paper we aim to predict the population-wide long-term effects on cervical cancer morbidity and mortality after introducing an HPV vaccination for 12-year-old girls (and boys) in addition to current screening in comparison with screening only. Methods Health effects are predicted by a dynamic transmission model that was previously applied in the UK and the Norwegian contexts and validated for Austria. Outcomes analyzed are restricted to cervical cancer mortality and morbidity, which are predicted until 2060 assuming a coverage rate between 65% and 85%, a duration of protection between 10 years and lifelong, and a vaccine efficacy between 80% and 100% in the base case and best case, respectively. Additionally, implications for cancer epidemiology until 2088 are estimated. Results Compared to screening only, screening plus vaccination of 12-year-old girls (and boys) would result in a median reduction of 10% (15%) fewer new cancer cases and 13% (20%) fewer cervical cancer deaths under best case assumptions over 52 years in the overall female population. In 2060, female population-based incidence and mortality would decrease by 27% and 43%, respectively, when vaccinating girls only and by 37% and 45% when additionally vaccinating boys. After 2060, a continuous further decrease in incidence and mortality can be expected with a maximum of minus 43% and 53%, respectively, in 2088 when vaccinating girls only. Conclusion Although a constant decrease in cervical cancer incidence and mortality is to be expected after introducing a population-wide HPV vaccination program in Austria, the reduction predicted by this model is lower than expected from clinical trials. This is due to several factors, such as low coverage rate and the long time horizon required for generating the maximum benefit of the vaccination in the overall population. In the context of limited resources, for further reducing cervical cancer in Austria, HPV vaccination programs need to be weighed against other public health alternatives such as improving screening quality.

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Section: Discussioncontrasting

confidence: 56%

Section: Introductionmentioning

confidence: 99%

HPV-vaccination for the prevention of cervical cancer in Austria: a model based long-term prognosis of cancer epidemiology

Zechmeister

Blasio

Garnett³

2009

J Public Health

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“…The high risk HPV types 16 and 18, contribute to about 70% of cervical cancer cases (Smith et al, 2008;Seoud, 2011). Clinical trial studies have demonstrated that two vaccines (Gardasil ® and Cervarix ® ) have almost 100% efficacy in preventing persistent infection and the development of precancerous lesions caused by HPV16 and HPV18 (Kohli et al, 2007;Paavonen et al, 2009;Lehtinen et al, 2012;Schiffman and Wacholder, 2012).…”

Section: Introductionmentioning

confidence: 99%

Human Papillomavirus Vaccination Acceptability among Female University Students in South Africa

Hoque

Ghuman²,

Hal³

2013

Asian Pacific Journal of Cancer Prevention

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Background: The objectives of this present study were to assess the awareness of cervical cancer and its risk factors among female undergraduates in South Africa, and to determine the their level of acceptability of Human Papillomavirus (HPV) vaccination. Materials and Methods: This cross-sectional study was conducted in March 2013 among 440 full time undergraduate female students. Results: Of those students who never had sex (n=163), 96 (58.9%) had ever heard of cervical cancer and only 12 students (12.5%) knew that HPV causes cervical cancer. More than a third (35.4%) of the students correctly said that sexual intercourse before age of 18 years is a risk factor for cervical cancer and 55.2% of the students knew about the Pap smear test which is used for screening cervical cancer. The majority (77.3%) were willing to accept HPV vaccination. Results revealed that students who knew about the Pap smear test, and were aware that having multiple sex partners, sexual intercourse before the age of 18 years, smoking and having contracted any STDs are risk factors for cervical cancer were more likely to accept HPV vaccination compared to other groups. Conclusions: The general knowledge of South African female university students about cervical cancer is not sufficient but they have positive attitudes toward getting vaccinated with the HPV vaccine.

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“…Questi modelli dimostrano come la vaccinazione anti HPV, in aggiunta ai programmi di screening, comporta tanto una riduzione significativa del rischio di contrarre il cervicocarcinoma, quanto una riduzione dei risultati anormali del pap test [6,7].…”

Section: Il Modello Per L'impatto Della Vaccinazione Anti Hpvunclassified

L’introduzione del vaccino anti-HPV bivalente adiuvato con AS04 nelle regioni italiane: impatto economico ed effetti sulla salute delle donne

Cavallo¹,

Cipriani²,

Gerzeli³

et al. 2008

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Introduction: the impact of cervical cancer prevention, in particular through HPV female vaccination, has been published for many countries at the national level. However, to our knowledge no attempt has been made to address the impact at a regional level. Since the Italian health reforms of the early 1990s, introducing "managerialism", decentralization and quasi-market mechanisms, regional authorities have consequently been experimenting with different organizational and funding models to achieve an acceptable combination of equity, efficiency, freedom of choice and cost-containment. Methods: a Markov model, previously described and successfully adapted to the national scenario [La Torre, 2007], has been used to explore the impact of preventive cervical cancer vaccination with Cervarix™ at a regional level in Italy. Resource use was based on a standard therapeutic path applied to all regions. However we quantified the impact of the so-called "decentralization progress" by collecting regional data on: pap-test coverage, tariffs for treatments and cost of the vaccination course. We performed for each Italian region a costeffectiveness analysis combined with a regional budget impact analysis. The regional analyses compared HPV vaccination, both of a single female cohort (12 years old) and a multiple female cohort (12+16 years old), plus screening to screening only. Results: 21 regional reports were produced presenting regional results on screening coverage, treatments costs, ICER and ICUR, net cost per subject vaccinated etc. Conclusions: national and regional analyses have two different aims: the former wants to address national regulatory agencies and needs to be representative of the national population whereas the latter deals with the real budget-holders, accountable in the eyes of patients. Furthermore in the Italian scenario, characterized by decentralization and local autonomy, a further level of detail is essential in order to describe the specific local settings and implications of a new health intervention. Keywords: Italian regions, HPV vaccination, economic & clinical impact(1) Università Bocconi, Milano (2) L'obiettivo della vaccinazione è la prevenzione del cancro e delle forme precancerose legate agli oncogeni maggiormente prevalenti: i ceppi 16 e 18 sono responsabili di circa il 70 per cento dei tumori in Europa [2]. Inoltre, il vaccino ha dimostrato anche un effetto di protezione crociata contro i ceppi 45 e 31 [3,4]. I ceppi HPV 16, 18 e 45 insieme sono responsabili in Europa di oltre otto casi di tumore su dieci [2].Dal gennaio 2007 in Italia la vaccinazione anti HPV è raccomandata dal SSN e come tale gratuita per le bambine nel dodicesimo anno di vita (dal compimento degli 11 anni fino al compimento dei 12 anni), erogata attraverso strutture pubbliche del Servizio Sanitario Na-PREMESSA L'oggetto dell'analisi Cervarix™, vaccino bivalente contro i tipi HPV 16 e 18 adiuvato con AS04, è stato approvato in tutti i paesi d'Europa per la prevenzione della neoplasia intraepiteliale della ...

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Estimating the long-term impact of a prophylactic human papillomavirus 16/18 vaccine on the burden of cervical cancer in the UK

Cited by 100 publications

References 36 publications

HPV-vaccination for the prevention of cervical cancer in Austria: a model based long-term prognosis of cancer epidemiology

HPV-vaccination for the prevention of cervical cancer in Austria: a model based long-term prognosis of cancer epidemiology

Human Papillomavirus Vaccination Acceptability among Female University Students in South Africa

L’introduzione del vaccino anti-HPV bivalente adiuvato con AS04 nelle regioni italiane: impatto economico ed effetti sulla salute delle donne

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