Health and economic impact of HPV 16 and 18 vaccination and cervical cancer screening in India
2008

Health and economic impact of HPV vaccination and cervical cancer screening in India

publication Evidence: high

Author Information

Author(s): Diaz M, Kim J J, Albero G, de Sanjosé S, Clifford G, Bosch F X, Goldie S J

Primary Institution: Harvard School of Public Health

Hypothesis

What is the potential health and economic impact of different cervical cancer prevention strategies in India?

Conclusion

Vaccination followed by screening three times per lifetime is expected to reduce cancer deaths by half and be cost-effective in India.

Supporting Evidence

  • Pre-adolescent vaccination alone reduced cancer incidence by 44%.
  • A combined approach of vaccination and screening provided a mean cancer reduction of 56-63%.
  • Vaccination followed by screening is expected to be cost-effective if the cost per vaccinated girl is less than I$10.
  • Screening strategies differ by test type, frequency, and number of visits required.
  • High coverage of vaccination is crucial for maximizing the benefits of the intervention.

Takeaway

This study shows that giving girls a vaccine to prevent cervical cancer and then screening them later can save many lives and is a good use of money.

Methodology

A computer-based model of cervical carcinogenesis was calibrated to epidemiologic data in India to compare health and economic impacts of vaccination and screening strategies.

Limitations

The analysis has uncertainties related to the natural history of HPV, type-specific immunity, and the lack of high-quality data on temporal trends of HPV-related disease.

Participant Demographics

The study focuses on women in India, particularly pre-adolescent girls for vaccination and adult women for screening.

Digital Object Identifier (DOI)

10.1038/sj.bjc.6604462

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