Mathematical models of cervical cancer prevention in the Asia Pacific region.
نویسندگان
چکیده
Using population-based and epidemiologic data for 25 countries in Asia (22 GAVI-Alliance eligible countries, Thailand, China and Japan), a model-based approach was used to estimate averted cervical cancer cases and deaths, disability-adjusted life years (DALYs) and incremental cost-effectiveness ratios (I$/DALY averted) for vaccination of young adolescent girls against human papillomavirus (HPV) types 16 and 18. Absolute reduction in lifetime cancer risk varied between countries, depending on incidence, proportion attributable to HPV-16 and -18, and population age-structure; for example, with 70% coverage, cancer reduction was 57% in Indonesia, whereas in Cambodia, it was 49%. Screening of women over age 30 three times per lifetime, after vaccinating them as pre-adolescents, is expected to provide an additional 20% to 30% mortality reduction. Of the 22 GAVI-Alliance eligible countries, India, Bangladesh, Vietnam and Indonesia account for 87% of the total DALYs averted. Assuming a cost per vaccinated girl of I$10 ($2 per dose), the cost per DALY averted is less than I$250 in 18 of 22 countries. Assuming a cost per vaccinated girl of I$25, the cost per DALY averted is I$1,360 in China compared with I$250 in Thailand, reflecting the greater number of girls that need to be vaccinated to prevent a death from cervical cancer in China. Vaccine price has an even greater effect on predicted affordability. For the 22 GAVI Alliance-eligible countries, vaccinating 5 consecutive birth cohorts at 70% coverage would cost over US $500 million versus almost US $1.3 billion at per dose costs of $2 and $5, respectively. Including China and Thailand would add US $251 million to US $1.4 billion at per dose prices of $2 and $12.25, respectively. In the countries we assessed, vaccination of young adolescent girls against HPV-16 and -18 could be very cost-effective if the cost per vaccinated girl is less than I$10-I$25; for it to be affordable, however, even with financing assistance, vaccine prices may need to be even lower.
منابع مشابه
Mapping HPV Vaccination and Cervical Cancer Screening Practice in the Pacific Region-Strengthening National and Regional Cervical Cancer Prevention.
OBJECTIVE To provide background information for strengthening cervical cancer prevention in the Pacific by mapping current human papillomavirus (HPV) vaccination and cervical cancer screening practices, as well as intent and barriers to the introduction and maintenance of national HPV vaccination programmes in the region. MATERIALS AND METHODS A cross-sectional questionnaire-based survey amon...
متن کاملTrade Potential of Turkey with Asia-Pacific Countries: Evidence from Panel Gravity Model
As a result of recent developments, global economic centre of gravity has slide to Asia-Pacific region. It is predicted that Asia-Pacific countries will take place at the first row in global trade and nearly a half of the total trade will intensify in this region at the year 2030. On the other hand, the region covers countries from different levels of development. These features of the region p...
متن کاملCervical Cancer Prevention Through HPV Vaccination in Low- and Middle-Income Countries in Asia
Cervical cancer is ranked the first or second most common cancer in women of low- and middle-income countries (LMICs) in Asia. Cervical cancer is almost exclusively caused by human papillomavirus (HPV), and majority of the cases can be prevented with the use of HPV vaccines. The HPV vaccines have demonstrated high vaccine efficacies against HPV infection and cervical cancer precursors in clinic...
متن کاملComprehensive cervical cancer prevention and control in the Asia Pacific region: the 6th Biennial Conference of the Asia Oceania Research Organization on Genital Infections & Neoplasia (AOGIN)
As the leading cancer killer of women in developing countries, cervical cancer accounts for more than a quarter million deaths each year, more than 50% of cases occur within the Asian-Pacific region, which can be prevented by appropriate interventions. Therefore, in 2005, we have developed an expert multi-disciplinary group within the region and along the lines of European Research Organization...
متن کاملA Comparative Appraisal of Roadway Accident for Asia-Pacific Countries
This paper describes an attempt to shed some light on road safety in Asia Pacific region by characterizing and assessing its road accidents. The relevant national road accident data were extracted from centralized data sources of international agencies. Due to data incompleteness and missing values, 21 Asia Pacific countries, presenting more than half of the world’s population, were selected fo...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Vaccine
دوره 26 Suppl 12 شماره
صفحات -
تاریخ انتشار 2008