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ArticlePublication 2007Modeling HPV and Cervical Cancer in the U.S. for Analyses of Screening and Vaccination
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty …
This paper discusses a model of human papillomavirus (HPV) and cervical cancer that incorporates uncertainty about the natural history of disease that was used to provide quantitative insight into U.S. policy choices for cervical cancer prevention. The authors developed a stochastic microsimulation of cervical cancer that distinguishes different HPV types by their incidence, clearance, persistence, and progression. For each set of sampled input parameters, likelihood-based goodness-of-fit (GOF) scores were computed based on comparisons between model-predicted…
Microsimulation | Calibration/Validation | Clinical Care | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Science/Technology | North America -
ArticlePublication 2011Model-Based Analyses to Compare Health and Economic Outcomes of Cancer Control: Inclusion of Disparities
In order to identify strategies that improve both population health and ensure its equitable distribution, …
In order to identify strategies that improve both population health and ensure its equitable distribution, the authors developed a typology of cancer disparities that considers types of inequalities among black, white, and Hispanic populations across different cancers. This paper reports on the typology using an existing disease simulation model of cervical cancer that was calibrated to clinical, epidemiological, and cost data in the United States and presents characteristics important for policy discussions. The typology proposed…
State-Transition | Social Determinants | Clinical Care | Priority Setting/Ethics | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Culture/Society | Health/Medicine | Science/Technology | North America -
ArticlePublication 2015A Conceptual Model for Breast, Cervical, and Colorectal Cancer Screening
General frameworks of the cancer screening process are available, but none directly compare the process …
General frameworks of the cancer screening process are available, but none directly compare the process in detail across different organ sites. This limits the ability of medical and public health professionals to develop and evaluate coordinated screening programs that apply resources and population management strategies available for one cancer site to other sites. This paper presents a conceptual model that incorporates a single screening episode for breast, cervical, and colorectal cancers into a unified framework based…
Microsimulation | Clinical Care | Preferences/Values | Health Outcomes | Evidence Synthesis | Test Performance | Cost-Effectiveness Analysis | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology | North America -
GuidelinesPublication 2011HPV Vaccine Introduction in LMIC's: Guidance on the Use of Cost-Effectiveness Models
This article is a literature review of HPV vaccination models suitable for low-income and middle-income …
This article is a literature review of HPV vaccination models suitable for low-income and middle-income country use to provide information about the feasibility of using such models in a developing country setting. The authors evaluated models in terms of their capacity, requirements, limitations and comparability. Their literature review identified six HPV vaccination models suitable for low-income and middle-income country use and representative of the literature in terms of provenance and model structure. Each model was…
Mathematical Models | Calibration/Validation | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology | Global -
ReportPublication 2015Chapter 4: Cervical Cancer
This chapter focuses on the possibility of primary prevention of cervical cancer as a result …
This chapter focuses on the possibility of primary prevention of cervical cancer as a result of the introduction of two commercially available vaccines against human papillomavirus (HPV). Few low- and middle-income countries (LMICs) have initiated or sustained cytology-based cervical cancer prevention programs, and these countries experience very high incidence and mortality rates. Fortunately, alternative strategies to prevent cervical cancer have been investigated and extensively evaluated in these settings. The authors report findings from cost-effectiveness analyses…
Mathematical Models | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology | Global -
ArticlePublication 2011Health and Economic Impact of HPV 16/18 Vaccination and Cervical Cancer Screening in Eastern Africa
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe …
In this article the authors use epidemiologic data from Kenya, Mozambique, Tanzania, Uganda, and Zimbabwe to develop models of HPV-related infection and disease. For each country, they assessed HPV vaccination of girls before age 12 followed by screening with HPV DNA testing once, twice, or three times per lifetime (at ages 35, 40, 45). For women over age 30, they assessed only screening (with HPV DNA testing up to three times per lifetime or VIA…
Microsimulation | Calibration/Validation | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Science/Technology | Sub-Saharan Africa -
ArticlePublication 2007Including Boys in an HPV Vaccination Program: A CEA in a Low-Resource Setting
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination …
This paper looks at the cost-effectiveness of including boys vs girls alone in a pre-adolescent vaccination program against human papillomavirus (HPV) types 16 and 18 in Brazil. Using demographic, epidemiological, and cancer data from Brazil, the authors developed a dynamic transmission model of HPV infection between males and females. Model-projected reductions in HPV incidence under different vaccination scenarios were applied to a stochastic model of cervical carcinogenesis to project lifetime costs and benefits. They found that at 90%…
Microsimulation | Calibration/Validation | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health/Medicine | Latin America & Caribbean -
ReviewPublication 2006Modelling the Impact of HPV Vaccines on Cervical Cancer and Screening Programmes
The impact of human papillomavirus (HPV)-16/18 vaccination on the incidence of infection and disease can …
The impact of human papillomavirus (HPV)-16/18 vaccination on the incidence of infection and disease can be explored in a range of different models. Here we explore the epidemiological and economic impact of vaccination where screening is absent and where it is well established. The importance for epidemiology of assumptions about naturally-acquired immunity and heterogeneity in risk behaviors are highlighted, as are the importance for health economic outcomes of vaccine costs and the ability to modify…
Mathematical Models | Clinical Care | Health Outcomes | Decision Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Global -
ReviewPublication 2006Cost-Effectiveness of Cervical Cancer Screening
In the last two decades, computer-based models of cervical cancer screening have been used to …
In the last two decades, computer-based models of cervical cancer screening have been used to evaluate the cost-effectiveness of different secondary prevention policies. Analyses in countries with existing screening programs have focused on identifying the optimal screening interval, ages for starting and stopping screening, and consideration of enhancements to conventional cytology, such as human papillomavirus (HPV)-DNA testing as a triage for equivocal results or as a primary screening test for women over the age of…
Mathematical Models | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Health/Medicine | Science/Technology | Global -
ArticlePublication 2009Cost-Effectiveness of HPV Vaccination and Cervical Cancer Screening in Women Aged 30+ Years in the U.S.
The objective of the study was to assess the health and economic outcomes of HPV …
The objective of the study was to assess the health and economic outcomes of HPV vaccination in older U.S. women. The authors conducted a cost-effectiveness analysis with an empirically calibrated model using data from published literature; interventions included HPV vaccination added to screening strategies that differ by test (cytology or HPV DNA testing), frequency, and start age versus screening alone.They found that in the context of annual or biennial screening, HPV vaccination of women aged…
Microsimulation | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine | Science/Technology | North America -
ArticlePublication 2009Cost Effectiveness Analysis of Including Boys in a HPV Vaccination Program in the U.S.
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a …
This article reports on a societal-perspective cost effectiveness analysis of including preadolescent boys in a routine human papillomavirus (HPV) vaccination program for preadolescent girls. The analysis included girls and boys aged 12 years; interventions included HPV vaccination of girls alone and of girls and boys in the context of screening for cervical cancer. The authors found that with 75% vaccination coverage and an assumption of complete, lifelong vaccine efficacy, routine HPV vaccination of 12-year-old girls…
Microsimulation | Calibration/Validation | Dynamic Transmission | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Economics/Finance | Health/Medicine | North America -
ArticlePublication 2008Health and Economic Impact of HPV 16 and 18 Vaccination and Cervical Cancer Screening in India
As cervical cancer is a leading cause of cancer death among women in low-income countries, …
As cervical cancer is a leading cause of cancer death among women in low-income countries, with approximately 25% of cases worldwide occurring in India, these authors estimated the potential health and economic impact of different cervical cancer prevention strategies in India. After empirically calibrating a cervical cancer model to country-specific epidemiologic data, they projected cancer incidence, life expectancy, and lifetime costs (I$2005), and calculated incremental cost-effectiveness ratios (I$/YLS) for the following strategies: pre-adolescent vaccination of…
Microsimulation | Calibration/Validation | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | Asia & Pacific -
ArticlePublication 2008Health and Economic Implications of HPV Vaccination in the U.S.
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical …
This article reports on a study using models of HPV-16 and HPV-18 transmission and cervical carcinogenesis to compare the health and economic outcomes of vaccinating preadolescent girls in the US (at 12 years of age), and vaccinating older girls and women in catch-up programs (to 18, 21, or 26 years of age). The study also examined the health benefits of averting other HPV-16-related and HPV-18-related cancers, the prevention of HPV-6-related and HPV-11-related genital warts and…
Microsimulation | Calibration/Validation | Dynamic Transmission | Clinical Care | Cost-Effectiveness Analysis | Infectious Diseases | Chronic Disease/Risk | Health Systems | Economics/Finance | Health/Medicine | Science/Technology | North America