Estimation of the potential overall impact of human papillomavirus vaccination on cervical cancer cases and deaths.
Vaccine
; 32(6): 733-9, 2014 Feb 03.
Article
em En
| MEDLINE
| ID: mdl-24291200
ABSTRACT
BACKGROUND:
Human papillomavirus (HPV) vaccination offers potential for primary prevention of HPV-related pre-cancers and cancers as demonstrated in clinical trials. Mathematical models have estimated the potential real-life impact of vaccination on the burden of cervical cancer (CC). However, these are restricted to evaluations in a limited number of countries.METHODS:
Potential decline in CC cases and deaths with the AS04-adjuvanted HPV-16/18 vaccine of young girls naïve to HPV, was estimated at steady-state (vaccine coverage 0-100%) based on clinical trial and country-specific incidence data. Data on vaccine efficacy were taken from the end of study PATRICIA trial of the AS04-adjuvanted HPV-16/18 vaccine. The numbers of cases and deaths due to HPV-16/18 were estimated and compared with those due to any HPV type to estimate the additional cases prevented. This difference estimates CC cases and deaths avoided due to protection against non-vaccine HPV types. Cost-offsets due to reductions in CC treatment were estimated for five countries (Brazil, Canada, Italy, Malaysia and South African Republic) using country-specific unit cost data. Additionally, cervical intraepithelial neoplasia grade 2 or 3 (CIN2/3)-related burden (cases and treatment costs) prevented by vaccination were estimated for two countries (Italy and Malaysia).RESULTS:
HPV vaccination could prevent a substantial number of CC cases and deaths in countries worldwide, with associated cost-offsets due to reduced CC treatment. Cross-protection increased the estimated potential number of CC cases and deaths prevented by 34 and 18% in Africa and Oceania, respectively. Moreover, vaccination could result in a substantial reduction in the number of CIN2/3 lesions and associated costs.CONCLUSION:
HPV vaccination could reduce the burden of CC and precancerous lesions in countries worldwide, part of disease burden reduction being related to protection against non HPV-16/18 related types.Palavras-chave
CC; CIN; Cervical cancer; HPV; HSIL; Human papillomavirus; ICO; Institut Català d'Oncologia; LEEP; LLETZ; TVC; VE; Vaccination; WHO; World Health Organization; cervical cancer; cervical intraepithelial neoplasia; high-grade squamous intraepithelial lesion; human papillomavirus; large loop excision of the transformation zone.; loop electrosurgical excision procedure; total vaccinated cohort; vaccine efficacy
Texto completo:
1
Coleções:
01-internacional
Contexto em Saúde:
10_ODS3_salud_sexual_reprodutiva
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1_ASSA2030
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2_ODS3
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6_ODS3_enfermedades_notrasmisibles
Base de dados:
MEDLINE
Assunto principal:
Neoplasias do Colo do Útero
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Vacinação em Massa
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Infecções por Papillomavirus
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Vacinas contra Papillomavirus
Tipo de estudo:
Clinical_trials
Limite:
Female
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Humans
País/Região como assunto:
Africa
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Asia
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Europa
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Mexico
Idioma:
En
Revista:
Vaccine
Ano de publicação:
2014
Tipo de documento:
Article