The health and economic impact of scaling cervical cancer prevention in 50 low- and lower-middle-income countries.


Campos, NG; Sharma, M; Clark, A; Lee, K; Geng, F; Regan, C; Kim, J; Resch, S; (2017) The health and economic impact of scaling cervical cancer prevention in 50 low- and lower-middle-income countries. International journal of gynaecology and obstetrics, 138 Suppl 1. pp. 47-56. ISSN 0020-7292 DOI: 10.1002/ijgo.12184

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Abstract

To estimate the health impact, financial costs, and cost-effectiveness of scaling-up coverage of human papillomavirus (HPV) vaccination (young girls) and cervical cancer screening (women of screening age) for women in countries that will likely need donor assistance. We used a model-based approach to synthesize population, demographic, and epidemiological data from 50 low- and lower-middle-income countries. Models were used to project the costs (US $), lifetime health impact (cervical cancer cases, deaths averted), and cost-effectiveness (US $ per disability adjusted life year [DALY] averted) of: (1) two-dose HPV-16/18 vaccination of girls aged 10 years; (2) once-in-a-lifetime screening, with treatment when needed, of women aged 35 years with either HPV DNA testing or visual inspection with acetic acid (VIA); and (3) cervical cancer treatment over a 10-year roll-out. We estimated that both HPV vaccination and screening would be very cost-effective, and a comprehensive program could avert 5.2 million cases, 3.7 million deaths, and 22.0 million DALYs over the lifetimes of the intervention cohorts for a total 10-year program cost of US $3.2 billion. Investment in HPV vaccination of young girls and cervical cancer screen-and-treat programs in low- and lower-middle-income countries could avert a substantial burden of disease while providing good value for public health dollars.

Item Type: Article
Faculty and Department: Faculty of Public Health and Policy > Dept of Health Services Research and Policy
PubMed ID: 28691334
Web of Science ID: 405091100009
URI: http://researchonline.lshtm.ac.uk/id/eprint/4052690

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