title: Time for change? An economic evaluation of integrated cervical screening and HPV immunization programs in Canada.
abstract: Many jurisdictions have implemented universal human papillomavirus (HPV) immunization programs in preadolescent females. However, the cost-effectiveness of modified cervical screening guidelines and/or catch-up immunization in older females in Canada has not been evaluated. We conducted a cost-utility analysis of screening and immunization with the bivalent vaccine for the Canadian setting from the Ministry of Health perspective. We used a dynamic model to capture herd immunity and included cross-protection against strains not included in the vaccine. We found that adding catch-up immunization to the current program would be cost-effective, and that combining catch-up immunization with delaying the age at which screening is first initiated could result in cost savings and net health gains.
authors.affiliation: Department of Mathematics and Statistics, University of Guelph, Canada.
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Tully
authors.forename: Andrea M
authors.initials: AM
authors.lastname: Anonychuk
authors.forename: Diana Maria
authors.initials: DM
authors.lastname: Sanchez
authors.forename: Alison P
authors.initials: AP
authors.lastname: Galvani
authors.forename: Chris T
authors.initials: CT
authors.lastname: Bauch
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002170:Canada; D003362:Cost-Benefit Analysis; D056738:Cross Protection; D055088:Early Detection of Cancer / Q000191:economics* / Q000379:methods*; D005260:Female; D006801:Humans; D032521:Immunity, Herd; D017589:Immunization Programs; D008297:Male; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis*; D053918:Papillomavirus Vaccines / Q000008:administration & dosage* / Q000191:economics*; D002583:Uterine Cervical Neoplasms / Q000276:immunology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D053918:Papillomavirus Vaccines