Will cervical screening remain cost-effective in women offered the next generation nonavalent HPV vaccine? Results for four developed countries.
dc.contributor.author | Simms, K | |
dc.contributor.author | Smith, M | |
dc.contributor.author | Lew, J | |
dc.contributor.author | Kitchener, Henry C | |
dc.contributor.author | Castle, P | |
dc.contributor.author | Canfell, K | |
dc.date.accessioned | 2016-10-05T10:07:07Z | |
dc.date.available | 2016-10-05T10:07:07Z | |
dc.date.issued | 2016-08-19 | |
dc.identifier.citation | Will cervical screening remain cost-effective in women offered the next generation nonavalent HPV vaccine? Results for four developed countries. 2016: Int. J. Cancer | en |
dc.identifier.issn | 1097-0215 | |
dc.identifier.pmid | 27541596 | |
dc.identifier.doi | 10.1002/ijc.30392 | |
dc.identifier.uri | http://hdl.handle.net/10541/619925 | |
dc.description.abstract | A next generation nonavalent human papillomavirus (HPV) vaccine ('HPV9 vaccine') is being introduced in several countries. The aims of this study were to evaluate whether cervical screening will remain cost-effective in cohorts offered nonavalent vaccines and if so, to characterize the optimal number of screening tests. We used a dynamic model of HPV vaccination and cervical screening to evaluate the cost-effectiveness of strategies involving varying numbers of primary HPV tests per lifetime for cohorts offered the nonavalent vaccine as 12 year-olds. For each of four countries - the USA, New Zealand (NZ), Australia and England - we considered local factors including vaccine uptake rates (USA/NZ uptake ∼50%; Australia/England uptake >70%); attributable fractions of HPV9-included types; demographic factors, costs and indicative willingness-to-pay (WTP) thresholds. Extensive sensitivity analysis was performed. We found that, in the USA, four screens per lifetime was the most likely scenario, with a 34% probability of being optimal at WTP US$50,000/LYS, increasing to 84% probability US$100,000/LYS. In New Zealand, five screens per lifetime was the most likely scenario, with 100% probability of being optimal at NZ$42,000/LYS. In Australia, two screens per lifetime was the most likely scenario, with 62% probability of being optimal at AU$50,000/LYS. In England, four screens per lifetime was the most likely scenario, with 32% probability of being optimal at WTP of GB£20,000/QALY, increasing to 92% probability at GB£30,000/QALY. We conclude that some cervical screening will remain cost-effective, even in countries with high vaccination coverage. However, the optimal number of screens may vary between countries. This article is protected by copyright. All rights reserved. | |
dc.language | ENG | |
dc.language.iso | en | en |
dc.rights | Archived with thanks to International journal of cancer | en |
dc.title | Will cervical screening remain cost-effective in women offered the next generation nonavalent HPV vaccine? Results for four developed countries. | en |
dc.type | Article | en |
dc.contributor.department | Cancer Research Division, Cancer Council NSW, 153 Dowling Street, Woolloomooloo, Sydney, NSW, 2011, Australia | en |
dc.identifier.journal | International Journal of Cancer | en |
html.description.abstract | A next generation nonavalent human papillomavirus (HPV) vaccine ('HPV9 vaccine') is being introduced in several countries. The aims of this study were to evaluate whether cervical screening will remain cost-effective in cohorts offered nonavalent vaccines and if so, to characterize the optimal number of screening tests. We used a dynamic model of HPV vaccination and cervical screening to evaluate the cost-effectiveness of strategies involving varying numbers of primary HPV tests per lifetime for cohorts offered the nonavalent vaccine as 12 year-olds. For each of four countries - the USA, New Zealand (NZ), Australia and England - we considered local factors including vaccine uptake rates (USA/NZ uptake ∼50%; Australia/England uptake >70%); attributable fractions of HPV9-included types; demographic factors, costs and indicative willingness-to-pay (WTP) thresholds. Extensive sensitivity analysis was performed. We found that, in the USA, four screens per lifetime was the most likely scenario, with a 34% probability of being optimal at WTP US$50,000/LYS, increasing to 84% probability US$100,000/LYS. In New Zealand, five screens per lifetime was the most likely scenario, with 100% probability of being optimal at NZ$42,000/LYS. In Australia, two screens per lifetime was the most likely scenario, with 62% probability of being optimal at AU$50,000/LYS. In England, four screens per lifetime was the most likely scenario, with 32% probability of being optimal at WTP of GB£20,000/QALY, increasing to 92% probability at GB£30,000/QALY. We conclude that some cervical screening will remain cost-effective, even in countries with high vaccination coverage. However, the optimal number of screens may vary between countries. This article is protected by copyright. All rights reserved. |