Nicole G Campos1, Monisha Sharma2, Andrew Clark3, Kyueun Lee4, Fangli Geng1, Catherine Regan1, Jane Kim1, Stephen Resch1. 1. Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA. 2. Department of Epidemiology, School of Public Health, University of Washington Seattle, Seattle, WA, USA. 3. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK. 4. Department of Health Research and Policy, Stanford University, Stanford, CA, USA.
Abstract
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.
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.
Authors: Julia M Lemp; Jan-Walter De Neve; Hermann Bussmann; Simiao Chen; Jennifer Manne-Goehler; Michaela Theilmann; Maja-Emilia Marcus; Cara Ebert; Charlotte Probst; Lindiwe Tsabedze-Sibanyoni; Lela Sturua; Joseph M Kibachio; Sahar Saeedi Moghaddam; Joao S Martins; Dismand Houinato; Corine Houehanou; Mongal S Gurung; Gladwell Gathecha; Farshad Farzadfar; Scott Dryden-Peterson; Justine I Davies; Rifat Atun; Sebastian Vollmer; Till Bärnighausen; Pascal Geldsetzer Journal: JAMA Date: 2020-10-20 Impact factor: 56.272
Authors: Jyoshma Preema Dsouza; Stephan Van den Broucke; Sanjay Pattanshetty; William Dhoore Journal: BMC Womens Health Date: 2022-06-16 Impact factor: 2.742