Top

BMC Public Health

Published in:

Open Access 01-12-2017 | Research article

Systematic review of cost-effectiveness analyses for combinations of prevention strategies against human papillomavirus (HPV) infection: a general trend

Authors: Frédéric Gervais, Kyle Dunton, Yiling Jiang, Nathalie Largeron

Published in: BMC Public Health | Issue 1/2017

Abstract

Background

Due to the arrival of multi-valent HPV vaccines, it is more and more important to have a better understanding of the relationship between vaccination and screening programmes. This review aimed to: (1) collect published evidence on the cost-effectiveness profile of different HPV prevention strategies and, in particular, those combining vaccination with changes in screening practices; (2) explore the cost-effectiveness of alternative preventive strategies based on screening and vaccination.

Methods

A systematic literature review was conducted in order to identify the relevant studies regarding the cost-effectiveness of prevention strategies against HPV infection. Analysis comparing the modelling approaches between studies was made along with an assessment of the magnitude of impact of several factors on the cost-effectiveness of different screening strategies.

Results

A total of 18 papers were quantitatively summarised within the narrative. A high degree of heterogeneity was found in terms of how HPV prevention strategies have been assessed in terms of their economic and epidemiological impact, with variation in screening practice and valence of HPV vaccination found to have large implications in terms of cost-effectiveness.

Conclusions

This review demonstrated synergies between screening and vaccination. New prevention strategies involving multi-valence vaccination, HPV DNA test screening, delayed commencement and frequency of screening could be implemented in the future. Strategies implemented in the future should be chosen with care, and informed knowledge of the potential impact of all possible prevention strategies. Highlighted in this review is the difficulty in assessing multiple strategies. Appropriate modelling techniques will need to be utilised to assess the most cost-effective strategies.

Available only for authorised users

Centers for Disease Control and Prevention. Genital HPV infection – CDC fact sheet. Available at, http://www.cdc.gov/std/hpv/stdfact-hpv.htm, Accessed 6 Jan 2014.

World health organization. Comprehensive cervical cancer control. A guide to essential practice. 2nd ed. 2014.

Sanjose S, Quint WGV, et al. Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol. 2010;11:1048–56.CrossRefPubMed

Schiller JT J, Day PM, Kines RC. Current understanding of the mechanism of HPV infection. Gynecol Oncol. 2010;118(1 Suppl):S12–7. doi:10.1016/j.ygyno.2010.04.004.CrossRefPubMedPubMedCentral

Longworth MS, Laimins LA. Pathogenesis of human papillomaviruses in differentiating epithelia. Microbiol Mol Biol Rev. 2004;68(2):362–72.CrossRefPubMedPubMedCentral

National Health Services. Genital warts. Available at http://www.nhs.uk/conditions/genital_warts/pages/introduction.aspx, Accessed 6 Jan 2014.

European Centre for Disease Prevention and Control. Introduction of HPV vaccines in European Union countries – an update. Available at http://ecdc.europa.eu/en/publications/Publications/20120905_GUI_HPV_vaccine_update.pdf. Accessed 6 Jan 2014.

Centres for disease control and prevention. Human papillomavirus (HPV) – associated cancers. Available at: http://www.cdc.gov/cancer/hpv/statistics/. Accessed 16 Dec 2014.

de Kok IM, van Rosmalen J, Dillner J, Arbyn M, Sasieni P, Iftner T, et al. Primary screening for human papillomavirus compared with cytology screening for cervical cancer in European settings: cost effectiveness analysis based on a Dutch microsimulation model. BMJ. 2012;344:e670. doi:10.1136/bmj.e670.CrossRefPubMedPubMedCentral

10.

Cuzick J, Clavel C, Petry KU, Meijer CJ, Hoyer H, Ratnam S, Szarewski A, Birembaut P, Kulasingam S, Sasieni P, Iftner T. Overview of the European and North American studies on HPV testing in primary cervical cancer screening. Int J Cancer. 2006;119(5):1095–101.CrossRefPubMed

11.

Canadian Cancer Society. Cervical cancer statistics. Available at http://www.cancer.ca/en/cancer-information/cancer-type/cervical/statistics/?region = on, Accessed 27 July 2016.

12.

Australian Government. Cervical cancer in Australia. Accessed 27th, July 2016 http://www.cervix.cz/index-en.php?pg=professionals--cervical-cancer-epidemiology

13.

American Cancer Society. Cervical Cancer. http://www.cancer.org/cancer/cervicalcancer/detailedguide/cervical-cancer-key-statistics. Accessed 27 July 2016.

14.

Bonnez W, Reichman RC. Papillomaviruses. In: Mandell GL, Bennett JE, Dolin R, editors. Principles and practice of infectious diseases. 7th ed. Philadelphia: Churchill Livingstone Elsevier; 2010. p. 2035–49.

15.

Lynge E, Rygaard C, Baillet M, Dugúe A, Sander B, Bonde J, Rebolj M. Cervical cancer screening at crossroads. Apmis. 2014;122(8):667–73. doi:10.1111/apm.12279.CrossRefPubMed

16.

Gibb RK, Martens MG. The impact of liquid-based cytology in decreasing the incidence of cervical cancer. Rev Obstet Gynecol. 2011;4 Suppl 1:S2–S11.PubMedPubMedCentral

17.

Tota J, Ramana-Kumar A, El-Khatib Z, Franco E. The road ahead for cervical cancer prevention and control. Current Oncology. 2014;21(2). http://dx.doi.org/10.3747/co.21.1720.

18.

Powell N, Cuschieri K, Cubie H, Hibbitts S, et al. Cervical cancers associated with human papillomavirus types 16, 18 and 45 are diagnosed in younger women than cancers associated with other types: A cross-sectional observational study in Wales and Scotland (UK). J Clin Virol. 2013:1–4. http://dx.doi.org/10.1016/j.jcv.2013.08.020.

19.

Sasieni P. Research Effectiveness of cervical screening with age: population based case–control study of prospectively recorded data. BMJ. 2009;339:b2968. doi: http://dx.doi.org/10.1136/bmj.b2968.CrossRefPubMedPubMedCentral

20.

Ronco G, Dillner J, Elfström K, Tunesi S, et al. Efficacy of HPV-based screening for prevention of invasive cervical cancer: follow-up of four European randomised controlled trials. Lancet. 2014;383(9916):524–32. doi: http://dx.doi.org/10.1016/S0140-6736(13)62218-7.CrossRefPubMed

21.

Gardasil. Electronic Medicines Compendium. From: http://www.medicines.org.uk/emc/medicine/19016/SPC/gardasil/Accessed: 6 Oct 2014.

22.

Cervarix. Electronic Medicines Compendium. From: http://www.medicines.org.uk/emc/medicine/20204/SPC/Cervarix/Accessed: 6 Oct 2014.

23.

Hartwig S, Baldauf J, Dominiak-Felden G, et al. Estimation of the epidemiological burden of HPV-related anogenital cancers, precancerous lesions, and genital warts in women and men in Europe: Potential additional benefit of a nine-valent second generation. Papillomavirus Res. 2015. (in press) HPV vaccine compared to first generation HPV vaccines.

24.

Brisson M. Incremental Cost-Effectiveness of the 9-valent vs. the 4-valent HPV vaccine in the U.S. Université Laval. In: Advisory Committee on Immunization Practices (ACIP) meeting. Atlanta; 2014.

25.

Mendes D, Bains T, Vanni T, et al. Systematic review of model-based cervical screening evaluations. BMC Cancer. 2015;15:334.

26.

Canfell K, Chesson H, Kulasingham SL, Berkhof J, Diaz M, Kim JJ. Modelling preventative strategies against human papillomavirus-related disease in developed countries. Vaccine. 2012;30(S5):167. doi:10.1016/j.vaccine.2012.06.091.

27.

Kulasingam SI, Myers ER. Potential health and economic impact of adding a human papillomavirus vaccine to screening programs. JAMA. 2003;290(6):781–90. doi:10.1001/jama.290.6.781.CrossRefPubMed

28.

Sanders GD, Taira AV. Cost effectiveness of a potential vaccine for human papillomavirus. Emerg Infect Dis. 2003;6(1):37–45.CrossRef

29.

Goldie SJ, Kohli M, Grima D, Weinstein MC, Wright TC, Bosch X, Franco E. Projected clinical benefits and cost–effectiveness of a human papillomavirus 16/18 vaccine. J Natl Cancer Inst. 2004;96(8):604–16. doi:10.1093/jnci/djh104.CrossRefPubMed

30.

Kim JJ, Goldie SJ. Cost effectiveness analysis of including boys in a human papillomavirus vaccination programme in the United States. BMJ. 2009;339:b3884. doi:10.1136/bmj.b3884.CrossRefPubMedPubMedCentral

31.

Kim JJ, Goldie SJ. Health and economic implications of HPV vaccination in the United States. N Eng J. 2008;359(8):821–32. doi:10.1056/NEJMsa0707052.CrossRef

32.

Taira AV, Neukermans CP, Sanders GD. Evaluating human papillomavirus vaccination programs. Emerg Infect Dis. 2004;10(11):1915–24.CrossRefPubMedPubMedCentral

33.

Goldhaber-Fiebert JD, Stout NK, Salomon JA, Kuntz KM, Goldie SJ. Cost-effectiveness of cervical cancer screening with human papillomavirus DNA testing and HPV-16, 18 vaccination. J Natl Cancer Inst. 2008;100(5):308–20. doi:10.1093/jnci/djn019.CrossRefPubMedPubMedCentral

34.

Kim JJ, Orthendahl BS, Goldie SJ. Cost-effectiveness of HPV vaccination and cervical cancer screening I women over age 30 in the United States. Ann Intern Med. 2009;151(8):538–45.CrossRefPubMedPubMedCentral

35.

Coupe VMH, de Melker HE, Snijders PJF, Meijer CJLM, Berkhof J. How to screen for cervical cancer after HPV16/18 vaccination in the Netherlands. Vaccine. 2009;27:5111–9. doi:10.1016/j.vaccine.2009.06.043.CrossRefPubMed

36.

Coupe VMH, van Ginkel J, de Melker HE, Snijders PJF, Meijer CJLM, Berkhof J. HPV16/18 vaccination to prevent cervical cancer in the Netherlands: model-based cost-effectiveness. Int J Cancer. 2008;124:970–8. doi:10.1002/ijc.24000.CrossRef

37.

Coupe VMH, Bogaards JA, Meijer CJLM, Berkhof J. Impact of vaccine protection against multiple HPV types on the cost-effectiveness of cervical screening. Vaccine. 2012;30(10):1913–822. doi:10.1016/j.vaccine.2012.01.001.CrossRef

38.

Accetta G, Biggeri A, Carreras G, Lippi G, Carozzi FM, Confortini M, Zappa M, Paci E. Is human papillomavirus screening preferable to current policies in vaccinated and unvaccinated women? A cost-effectiveness analysis. J Med Screen. 2010;17:181–9. doi:10.1258/jms.2010.010019.CrossRefPubMed

39.

Kulasingham S, Connelly L, Conway E, Hocking JS, Myers E, Regan DG, Roder D, Ross J, Wain G. A cost-effectiveness analysis of adding a human papillomavirus to the Australian national screening program. Sex Health. 2007;4:165–75. http://dx.doi.org/10.1071/SH07043.CrossRef

40.

Tully SP, Anonychuk AM, Sanchez DM, Galvani AP, Bauch CT. Time for change? An economic evaluation of integrated cervical screening and HPV immunization programs in Canada. Vaccine. 2011;30:425–35. doi:10.1016/j.vaccine.2011.10.067.CrossRefPubMed

41.

Demarteau N, Detournay B, Tehard B, El Hasnaoui A, Standaert B. A generally applicable cost-effectiveness model for the evaluation of vaccines against cervical cancer. Int J Public Health. 2009;56:153–62. doi:10.1007/s00038-010-0216-6.CrossRef

42.

Burger EA, Ortendahl JD, Sy S, Kritiansen IS, Kim JJ. Cost-effectiveness of cervical cancer screening with primary human papillomavirus testing in Norway. Br J Cancer. 2012;106:1571–8. doi:10.1038/bjc.2012.94.CrossRefPubMedPubMedCentral

43.

Diaz M, de Sanjose S, Orthendahl J, O’Shea M, Goldie SJ, Bosch FX, Kim JJ. Cost-effectiveness of human papillomavirus vaccination and screening in Spain. Eur J Cancer. 2010;46:2973–85. doi:10.1016/j.ejca.2010.06.016.CrossRefPubMed

44.

Berkhof J, Bogaards JA, Demirel E, Diaz M, Sharma M, Kim JJ. Cost-effectiveness of cervical cancer prevention in Central and Eastern Europe and Central Asia. Vaccine. 2013;31S:H71–9. http://dx.doi.org/10.1016/j.vaccine.2013.04.086.CrossRef

45.

Simms K, Smith M, Lew JB, et al. How often will cervical screening be required in women offered next generation nonavalent HPV vaccine? Int J Cancer. 2016 Dec 15;139(12):2771-80. doi:10.1002/ijc.30392.

46.

Cuzick J. Gardasil 9 joins the fight against cervix cancer. Expert Rev Vaccines. 2015;14(8):1047–9. doi:10.1586/14760584.2015.1051470.

47.

Canfell K, Lew J, Simms K, Kang Y, Xu X, Caruana M, Walker R, Smith M. Optimal screening strategies in the era of vaccination in terms of cost-effectiveness – Australia. Eurogin; 2015. Abstract SS 6–1. Lowy Cancer Research Centre, Prince of Wales Clinical School, UNSW Australia, Sydney, Australia.

48.

Naber K, Matthijsse S, Rozemeijer K, et al. Cervical cancer screening in partly HPV vaccinated cohorts – a cost effectiveness analysis. PLoS One. 2016;11(1):1–15. doi:10.1371/journal.pone.0145548.CrossRef

49.

Simonella L, Canfell K. Development of a quality framework for models of cervical screening and its application to evaluations of the cost-effectiveness of HPV vaccination in developed countries. Vaccine. 2015;33(1):34–51. doi:10.1016/j.vaccine.2014.08.048. Epub 2014 Aug 27. Review.CrossRefPubMed

50.

Sander B, Wong WW, Yeung MW, Ormanidhi O, Atkin K, Murphy J, Krahn M, Deeks SL. The cost-utility of integrated cervical cancer prevention strategies in the Ontario setting - Can we do better? Vaccine. 2016. doi:10.1016/j.vaccine.2016.02.016. [Epub ahead of print] PubMed PMID: 26892739.PubMed

51.

De Vincenzo R, Conte C, Ricci C, Scambia G. Giovanni Capelli Long-term efficacy and safety of human papillomavirus vaccination. Int J Women’s Health. 2014;6:999–1010.CrossRef

52.

World Health Organization. Comprehensive Cerival Cancer Control – A guide to essential practice – 2nd edition. 2014.

53.

Isidean S, Tota J, Gagnon J, Franco E. Human papillomavirus vaccines: key factors in planning cost-effective vaccination programs. Expert Rev Vaccines. 2015;14(1):119–33. doi:10.1586/14760584.2015.964213.CrossRefPubMed

54.

Mendes D, Bains I, Vanni T, et al. Systematic review of model-based cervical screening evaluations. BMC Cancer. 2015;15:334. doi:10.1186/s12885-015-1332-8.CrossRefPubMedPubMedCentral

55.

Baussano I. Effectiveness and impact of different HPV vaccination and screening strategies. HPV Today; 2014. Number 32–33: pp 14. Imperial College London.

Title: Systematic review of cost-effectiveness analyses for combinations of prevention strategies against human papillomavirus (HPV) infection: a general trend
Authors: Frédéric Gervais
Kyle Dunton
Yiling Jiang
Nathalie Largeron
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-017-4076-3

At a glance: The STEP trials

Springer Medicine

Systematic review of cost-effectiveness analyses for combinations of prevention strategies against human papillomavirus (HPV) infection: a general trend

Abstract

Background

Methods

Results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2017

Effects of community health volunteers on infectious diseases of children under five in Volta Region, Ghana: study protocol for a cluster randomized controlled trial

Adolescent reserve capacity, socioeconomic status and school achievement as predictors of mortality in Finland - a longitudinal study

Views of Somali women and men on the use of faith-based messages promoting breast and cervical cancer screening for Somali women: a focus-group study

Capturing how age-friendly communities foster positive health, social participation and health equity: a study protocol of key components and processes that promote population health in aging Canadians

Caught between a rock and a hard place: mental health of migrant live-in caregivers in Canada

The effect of food insecurity on health status of adolescents in Ethiopia: longitudinal study