期刊
INTERNATIONAL JOURNAL OF GYNECOLOGY & OBSTETRICS
卷 138, 期 -, 页码 47-56出版社
WILEY
DOI: 10.1002/ijgo.12184
关键词
Cancer screening; Cost-effectiveness analysis; HPV; HPV DNA tests; Uterine cervical neoplasms
资金
- American Cancer Society [16300]
Objective: To estimate the health impact, financial costs, and cost-effectiveness of scaling-up coverage of human papillomavirus (HPV) vaccination (young girls) and cervical cancer screening (women of screening age) for women in countries that will likely need donor assistance. Methods: We used a model-based approach to synthesize population, demographic, and epidemiological data from 50 low-and lower-middle-income countries. Models were used to project the costs (US $), lifetime health impact (cervical cancer cases, deaths averted), and cost-effectiveness (US $ per disability adjusted life year [ DALY] averted) of: (1) two-dose HPV-16/18 vaccination of girls aged 10 years; (2) once-in-a-lifetime screening, with treatment when needed, of women aged 35 years with either HPV DNA testing or visual inspection with acetic acid (VIA); and (3) cervical cancer treatment over a 10-year roll-out. Results: We estimated that both HPV vaccination and screening would be very cost-effective, and a comprehensive program could avert 5.2 million cases, 3.7 million deaths, and 22.0 million DALYs over the lifetimes of the intervention cohorts for a total 10-year program cost of US $ 3.2 billion. Conclusion: Investment in HPV vaccination of young girls and cervical cancer screen-and-treat programs in low-and lower-middle-income countries could avert a substantial burden of disease while providing good value for public health dollars.
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