Impact of HPV vaccination: health gains in the Italian female population

Population Health Metrics

Research

Andrea Marcellusi¹ 

[1] National Research Council (CNR), Institute for Research on Population and Social Policies (IRPPS), Via Palestro 32, 00185, Rome, Italy;Department Accounting, Finance and Informatics, Kingston Business School Kingston University, London, UK;Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, University of Rome “Tor Vergata”, Rome, Italy;

关键词: HPV;    Burden of disease;    CIN1;    CIN2–3;    Anogenital warts;    Cervical cancer;    QALY;    Daly;   

DOI  :  10.1186/s12963-017-0154-0

 received in 2016-09-12, accepted in 2017-09-21,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundHuman papillomavirus (HPV) is the leading cause of cervical cancer and other malignant and benign neoplastic lesions. HPV vaccination has three potential goals: to prevent transmission, infection, and disease. At present, there are no available data about health consequences of HPV immunization in Italy. The aim of this study is to evaluate the effect of current HPV vaccination strategy in Italy.MethodsA multistate morbidity-mortality model was developed to estimate the infection process in a theoretical cohort of Italian women. The Markov process considered nine health states (health, anogenital warts, grade 1 and grade 2/3 cervical intraepithelial neoplasia, cervical cancer, anal cancer, death due to cervical cancer, anal cancer and other causes), and 26 transition probabilities for each age group. The model was informed with the available data in national and international literature. Effectiveness of immunization was assumed considering a literature review pertaining to models and vaccination coverage rates observed in Italy. Life expectancy (ex), Quality-Adjusted Life Years (QALYs), Disability-Adjusted Life Years (DALYs), and attributable risk (AR) were estimated for no intervention (cervical cancer screening) and vaccination strategies scenarios.ResultsThe model showed that in a cohort of 100,000 Italian women the e0 is equal to 83.1 years. With current HPV vaccination strategy the e0 achieves 83.2 (+0.1) years. When HPV-related diseases are considered altogether, the QALYs increase from 82.7 to 82.9 (+0.2 QALYs) with no intervention and vaccination strategies respectively. DALYs decrease by 0.6 due to vaccination. Finally, AR is equal to 93 and 265 cases per 100,000 women in population and not vaccinated, respectively.ConclusionWhen mortality due to cervical cancer is considered, HPV vaccination seems to have a low impact on health unit gains in the Italian female population. Conversely, when several HPV-related and cancer morbidity conditions are included, the effect of vaccination becomes quite remarkable.

【 授权许可】

CC BY   
© The Author(s). 2017

【 图 表 】

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