Optimization of primary and secondary cervical cancer prevention strategies in an era of cervical cancer vaccination: A multi-regional health economic analysis

Raina M. Rogoza, Nicole Ferko, James Bentley, Chris J L M Meijer, Johannes Berkhof, Kung Liahng Wang, Levi Downs, Jennifer S. Smith, Eduardo L. Franco

Research output: Contribution to journalArticlepeer-review

52 Scopus citations

Abstract

With the recent advent of cervical cancer vaccines, many questions relating to the best overall prevention methods for cervical disease are beginning to arise. A Markov model was used across five geographic regions (Canada, The Netherlands, Taiwan, UK, US) to examine the clinical benefits and cost-effectiveness of: (1) vaccination combined with screening, considering changes to screening-related parameters and (2) vaccination combined with screening, considering changes to screening policy. Given the assumptions used in this analysis, adding vaccination to current screening is likely to be cost-effective in the regions studied. When considering vaccination with several plausible changes to screening programmes, locations with the most frequent Papanicolaou smear testing may achieve the most efficiency gains by adopting a less frequent screening interval or incorporating HPV testing into their screening practices. Although it may be beneficial to change screening to maximize efficiency, the most cost-effective strategies for vaccination and screening combinations may not lead to the greatest reductions in cervical cancer; therefore such policy decisions may vary depending on region-specific goals. Finally, new screening paradigms such as primary HPV testing should be considered in future analyses.

Original languageEnglish (US)
Pages (from-to)F46-F58
JournalVaccine
Volume26
Issue numberSUPPL.5
DOIs
StatePublished - Sep 15 2008

Keywords

  • Cervical screening
  • Cost-effectiveness
  • HPV vaccines

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