Estimating the long-term impact of a prophylactic human papillomavirus 16/18 vaccine on the burden of cervical cancer in the UK.
To predict the public health impact on cervical disease by introducing human papillomavirus (HPV) vaccination in the United Kingdom, we developed a mathematical model that can be used to reflect the impact of vaccination in different countries with existing screening programmes. Its use is discussed in the context of the United Kingdom. The model was calibrated with published data. The impact of vaccination on cervical cancer and deaths, precancerous lesions and screening outcomes were estimated for a vaccinated cohort of 12-year-old girls, among which it is estimated that there would be a reduction of 66% in the prevalence of high-grade precancerous lesions and a 76% reduction in cervical cancer deaths. Estimates for various other measures of the population effects of vaccination are also presented. We concluded that it is feasible to forecast the potential effects of HPV vaccination in the context of an existing national screening programme. Results suggest a sizable reduction in the incidence of cervical cancer and related deaths. Areas for future research include investigation of the beneficial effects of HPV vaccination on infection transmission and epidemic dynamics, as well as HPV-related neoplasms in other sites.
Kohli
M
M
Health Economics and Outcomes Research, i3 Innovus, Burlington, Ontario, Canada. nferko@i3innovus.com
Ferko
N
N
Martin
A
A
Franco
E L
EL
Jenkins
D
D
Gallivan
S
S
Sherlaw-Johnson
C
C
Drummond
M
M
D002138:Calibration; D002648:Child; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D005260:Female; D006801:Humans; D008390:Markov Chains; D008403:Mass Screening; D015233:Models, Statistical; D053918:Papillomavirus Vaccines / Q000627:therapeutic use*; D011237:Predictive Value of Tests; D011634:Public Health; D012680:Sensitivity and Specificity; D006113:United Kingdom / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000517:prevention & control* / Q000821:virology
D053918:Papillomavirus Vaccines; C510352:human papillomavirus vaccine, L1 type 16, 18