Cost-effectiveness of a cervical screening program with human papillomavirus vaccine

Elizaveta (Liza) Sopina*, Toni Ashton

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Objectives: Recent introduction of a quadrivalent human papillomavirus (HPV) vaccine for girls in New Zealand is expected to decrease the incidence of HPV infection as well as resultant cytological abnormalities and cervical cancer. This may affect the cost-effectiveness of the national cervical screening program by reducing the incidence of lesions detected. This study investigates the cost-effectiveness of the current cervical screening policy with and without the HPV vaccine and compares these results with the cost-effectiveness of a range of other screening strategies. Methods: A Markov state-transition model was built based on the natural history of HPV and cervical carcinogenesis. The model followed a hypothetical cohort of girls from 12 years to 85 years of age or death, through screening and treatment pathways. The model compared a "no vaccine and current screening" strategy with a selection of screening strategies with different age ranges and frequency intervals. Results: The most cost-effective cervical screening strategy in the presence of the HPV vaccine would be screening women aged 30-60 every 5 years. Moving to this screening strategy from the base case of no vaccine and the current New Zealand strategy of screening women aged 20-69 every 3 years is predicted to have an incremental cost per quality-adjusted life-year gained of NZ$9,841 (€4,428). Conclusions: Reducing screening intensity from 3 to 5 years as well as narrowing the screening age range for the vaccinated cohort once they reach mid-twenties is recommended. The importance of achieving a high vaccine uptake in New Zealand remains high.

OriginalsprogEngelsk
TidsskriftInternational Journal of Technology Assessment in Health Care
Vol/bind27
Udgave nummer4
Sider (fra-til)290-297
ISSN0266-4623
DOI
StatusUdgivet - 1. okt. 2011
Udgivet eksterntJa

Fingeraftryk

Cost-Benefit Analysis
New Zealand
Quality-Adjusted Life Years
Incidence
Natural History
Uterine Cervical Neoplasms

Citer dette

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abstract = "Objectives: Recent introduction of a quadrivalent human papillomavirus (HPV) vaccine for girls in New Zealand is expected to decrease the incidence of HPV infection as well as resultant cytological abnormalities and cervical cancer. This may affect the cost-effectiveness of the national cervical screening program by reducing the incidence of lesions detected. This study investigates the cost-effectiveness of the current cervical screening policy with and without the HPV vaccine and compares these results with the cost-effectiveness of a range of other screening strategies. Methods: A Markov state-transition model was built based on the natural history of HPV and cervical carcinogenesis. The model followed a hypothetical cohort of girls from 12 years to 85 years of age or death, through screening and treatment pathways. The model compared a {"}no vaccine and current screening{"} strategy with a selection of screening strategies with different age ranges and frequency intervals. Results: The most cost-effective cervical screening strategy in the presence of the HPV vaccine would be screening women aged 30-60 every 5 years. Moving to this screening strategy from the base case of no vaccine and the current New Zealand strategy of screening women aged 20-69 every 3 years is predicted to have an incremental cost per quality-adjusted life-year gained of NZ$9,841 (€4,428). Conclusions: Reducing screening intensity from 3 to 5 years as well as narrowing the screening age range for the vaccinated cohort once they reach mid-twenties is recommended. The importance of achieving a high vaccine uptake in New Zealand remains high.",
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author = "Sopina, {Elizaveta (Liza)} and Toni Ashton",
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Cost-effectiveness of a cervical screening program with human papillomavirus vaccine. / Sopina, Elizaveta (Liza); Ashton, Toni.

I: International Journal of Technology Assessment in Health Care, Bind 27, Nr. 4, 01.10.2011, s. 290-297.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Cost-effectiveness of a cervical screening program with human papillomavirus vaccine

AU - Sopina, Elizaveta (Liza)

AU - Ashton, Toni

PY - 2011/10/1

Y1 - 2011/10/1

N2 - Objectives: Recent introduction of a quadrivalent human papillomavirus (HPV) vaccine for girls in New Zealand is expected to decrease the incidence of HPV infection as well as resultant cytological abnormalities and cervical cancer. This may affect the cost-effectiveness of the national cervical screening program by reducing the incidence of lesions detected. This study investigates the cost-effectiveness of the current cervical screening policy with and without the HPV vaccine and compares these results with the cost-effectiveness of a range of other screening strategies. Methods: A Markov state-transition model was built based on the natural history of HPV and cervical carcinogenesis. The model followed a hypothetical cohort of girls from 12 years to 85 years of age or death, through screening and treatment pathways. The model compared a "no vaccine and current screening" strategy with a selection of screening strategies with different age ranges and frequency intervals. Results: The most cost-effective cervical screening strategy in the presence of the HPV vaccine would be screening women aged 30-60 every 5 years. Moving to this screening strategy from the base case of no vaccine and the current New Zealand strategy of screening women aged 20-69 every 3 years is predicted to have an incremental cost per quality-adjusted life-year gained of NZ$9,841 (€4,428). Conclusions: Reducing screening intensity from 3 to 5 years as well as narrowing the screening age range for the vaccinated cohort once they reach mid-twenties is recommended. The importance of achieving a high vaccine uptake in New Zealand remains high.

AB - Objectives: Recent introduction of a quadrivalent human papillomavirus (HPV) vaccine for girls in New Zealand is expected to decrease the incidence of HPV infection as well as resultant cytological abnormalities and cervical cancer. This may affect the cost-effectiveness of the national cervical screening program by reducing the incidence of lesions detected. This study investigates the cost-effectiveness of the current cervical screening policy with and without the HPV vaccine and compares these results with the cost-effectiveness of a range of other screening strategies. Methods: A Markov state-transition model was built based on the natural history of HPV and cervical carcinogenesis. The model followed a hypothetical cohort of girls from 12 years to 85 years of age or death, through screening and treatment pathways. The model compared a "no vaccine and current screening" strategy with a selection of screening strategies with different age ranges and frequency intervals. Results: The most cost-effective cervical screening strategy in the presence of the HPV vaccine would be screening women aged 30-60 every 5 years. Moving to this screening strategy from the base case of no vaccine and the current New Zealand strategy of screening women aged 20-69 every 3 years is predicted to have an incremental cost per quality-adjusted life-year gained of NZ$9,841 (€4,428). Conclusions: Reducing screening intensity from 3 to 5 years as well as narrowing the screening age range for the vaccinated cohort once they reach mid-twenties is recommended. The importance of achieving a high vaccine uptake in New Zealand remains high.

KW - Cervical cancer

KW - Cervical screening

KW - Cost-effectiveness

KW - HPV vaccine

U2 - 10.1017/S0266462311000456

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M3 - Journal article

C2 - 21936972

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JO - International Journal of Technology Assessment in Health Care

JF - International Journal of Technology Assessment in Health Care

SN - 0266-4623

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ER -