Cost-effectiveness analysis of human papillomavirus vaccines for the prevention of cervical cancer in India.

BACKGROUND: Human papillomavirus (HPV) vaccines represent an important strategic opportunity to prevent cervical cancer in low-middle income countries, such as India. The economic evaluation of HPV vaccines is crucial to inform public-health decisions; however, the scarce economic evaluations from India have focused on the value for money of bivalent vaccines and took a healthcare perspective. The aim of this study is to conduct a cost-effectiveness analysis of all available HPV vaccines in India. MATERIAL AND METHODS: The Papillomavirus Rapid Interface for Modelling and Economics (PRIME) model was used to evaluate the cost-effectiveness of HPV vaccination of 12-year-old girls in India, from both healthcare and societal perspectives. Cervical cancer cases, deaths averted and the incremental cost per Disability Adjusted Life Years (DALY) averted were reported as primary outcomes. Sensitivity analysis was undertaken to handle any uncertainty or variability in the results. RESULTS: Compared with no vaccination, the incremental cost per DALY averted was USD 362.78 for nonavalent vaccine, USD 393.16 for quadrivalent vaccine and USD 432.24 for bivalent vaccine from a healthcare perspective. From a societal perspective, the incremental cost per DALY averted was USD 334.28 for nonavalent vaccine, USD 364.67 for quadrivalent vaccine and USD 403.75 for bivalent vaccine. Assuming constant prices per dose for all vaccines, the nonavalent vaccine dominated both quadrivalent and bivalent vaccines, indicating that it is the more cost-effective strategy. CONCLUSION: Vaccinating girls against HPV is a cost-effective strategy to reduce the incidence of cervical cancer and mortality due to cervical cancer in India.

Guidelines for genetic testing in prostate cancer: a scoping review.

BACKGROUND: Genetic testing, to identify pathogenic or likely pathogenic variants in prostate cancer, is valuable in guiding treatment decisions for men with prostate cancer and to inform cancer prevention and early detection options for their immediate blood relatives. There are various guidelines and consensus statements for genetic testing in prostate cancer. Our aim is to review genetic testing recommendations across current guidelines and consensus statements and the level of evidence supporting those recommendations. METHODS: A scoping review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping review (PRISMA-ScR) guidelines. Electronic database searches and manual searches of grey literature, including websites of key organisations were conducted. Using the Population, Concept, Context (PCC) framework, this scoping review included: men with prostate cancer or men at high risk of prostate cancer and their biological families; existing guidelines and consensus statements with supporting evidence for genetic testing of men with prostate cancer from any geographical location worldwide. RESULTS: Of the 660 citations identified, 23 guidelines and consensus statements met the inclusion criteria for the scoping review. Based on different levels of evidence about who should be tested and how, a diverse range of recommendations were identified. There was general consensus among the guidelines and consensus statements that men with metastatic disease be offered genetic testing; however, there was less consensus in relation to genetic testing in localised prostate cancer. While there was some consensus in relation to which genes to test, recommendations varied regarding who to test, testing methods and implementation. CONCLUSION: While genetic testing in prostate cancer is routinely recommended and numerous guidelines exist, there is still considerable lack of consensus regarding who should be tested and how they should be tested. Further evidence is needed to inform value-based genetic testing strategies for implementation in practice.

Introgression and genetic mapping of leaf rust and stripe rust resistance in Aegilops triuncialis.

The growing and cultivating resistant wheat crop varieties is important to meet the demands of the growing population and minimizing the yield losses due to foliar diseases. More important is the identification of novel resistance sources and transfer of resistance in ready to use form. In the current study, leaf rust (LR) and stripe rust (YR) resistant tetraploid nonprogenitors of wheat Aegilops triuncialis (UtUtCtCt) acc pau 3462 was crossed and backcrossed susceptible cultivar WL711(NN) by inducing homeologous pairing using CS ph1. Recurrent parent type plants were selected in subsequent generation with resistance to LR and YR and BC2F7 introgression line (2n=42) named ILtri have been developed. To understand the nature and inheritance of LR and YR resistance genes and to map their genomic location, F2 and F2:3 mapping populations were developed by crossing ILtri with WL711(NN). In F2 and F2:3, the seedlings and adult plants segregated into 3R:1S and 1HR:2Seg:1HS ratios, respectively for both LR and YR, indicating inheritance of single dominant all stage resistance gene working against both the rusts. These genes were temporary designated as Lrtri and Yrtri and were inherited independently.Molecular mapping of 614 SSR markers mapped the Lrtri at a distance of 11.2 cM from SSR marker Xwmc606.