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

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Abstract

Background

Human 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.

Methods

A 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 (e _x), 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.

Results

The model showed that in a cohort of 100,000 Italian women the e ₀ is equal to 83.1 years. With current HPV vaccination strategy the e ₀ 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.

Conclusion

When 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.

Electronic supplementary material

The online version of this article (10.1186/s12963-017-0154-0) contains supplementary material, which is available to authorized users.

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Most cited references 40

Record: found
Abstract: found
Article: not found

Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women

J Paavonen, P Naud, J. Salmerón … (2009)

The Lancet, 374(9686), 301-314

0 comments Cited 452 times – based on 0 reviews      Review now

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Record: found
Abstract: found
Article: not found

A controlled trial of a human papillomavirus type 16 vaccine.

Laura Koutsky, Kevin A Ault, Cosette M. Wheeler … (2002)

Approximately 20 percent of adults become infected with human papillomavirus type 16 (HPV-16). Although most infections are benign, some progress to anogenital cancer. A vaccine that reduces the incidence of HPV-16 infection may provide important public health benefits. In this double-blind study, we randomly assigned 2392 young women (defined as females 16 to 23 years of age) to receive three doses of placebo or HPV-16 virus-like-particle vaccine (40 microg per dose), given at day 0, month 2, and month 6. Genital samples to test for HPV-16 DNA were obtained at enrollment, one month after the third vaccination, and every six months thereafter. Women were referred for colposcopy according to a protocol. Biopsy tissue was evaluated for cervical intraepithelial neoplasia and analyzed for HPV-16 DNA with use of the polymerase chain reaction. The primary end point was persistent HPV-16 infection, defined as the detection of HPV-16 DNA in samples obtained at two or more visits. The primary analysis was limited to women who were negative for HPV-16 DNA and HPV-16 antibodies at enrollment and HPV-16 DNA at month 7. The women were followed for a median of 17.4 months after completing the vaccination regimen. The incidence of persistent HPV-16 infection was 3.8 per 100 woman-years at risk in the placebo group and 0 per 100 woman-years at risk in the vaccine group (100 percent efficacy; 95 percent confidence interval, 90 to 100; P<0.001). All nine cases of HPV-16-related cervical intraepithelial neoplasia occurred among the placebo recipients. Administration of this HPV-16 vaccine reduced the incidence of both HPV-16 infection and HPV-16-related cervical intraepithelial neoplasia. Immunizing HPV-16-negative women may eventually reduce the incidence of cervical cancer. Copyright 2002 Massachusetts Medical Society

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Record: found
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Carcinoma of the cervix uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer.

U Beller, Ron Heintz, F E Odicino … (2006)

0 comments Cited 150 times – based on 0 reviews      Review now

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Author and article information

Contributors

Andrea Marcellusi: +393492748592 , andrea.marcellusi@uniroma2.it , andreamarcellusi@gmail.com

Journal

Journal ID (nlm-ta): Popul Health Metr

Journal ID (iso-abbrev): Popul Health Metr

Title: Population Health Metrics

Publisher: BioMed Central (London )

ISSN (Electronic): 1478-7954

Publication date (Electronic): 29 September 2017

Publication date PMC-release: 29 September 2017

Publication date Collection: 2017

Volume: 15

Electronic Location Identifier: 36

Affiliations

[1 ]ISNI 0000 0001 1940 4177, GRID grid.5326.2, National Research Council (CNR), Institute for Research on Population and Social Policies (IRPPS), ; Via Palestro 32, 00185 Rome, Italy

[2 ]ISNI 0000 0001 0536 3773, GRID grid.15538.3a, Department Accounting, Finance and Informatics, , Kingston Business School Kingston University, ; London, UK

[3 ]ISNI 0000 0001 2300 0941, GRID grid.6530.0, Economic Evaluation and HTA (EEHTA), CEIS, Faculty of Economics, , University of Rome “Tor Vergata”, ; Rome, Italy

Article

Publisher ID: 154

DOI: 10.1186/s12963-017-0154-0

PMC ID: 5622511

PubMed ID: 28962572

SO-VID: 4835bb02-bcb5-471e-b411-c7d92e0152b0

License:

Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

History

Date received : 12 September 2016

Date accepted : 21 September 2017

Custom metadata

ScienceOpen disciplines: Health & Social care

Keywords: hpv,burden of disease,cin1,cin2–3,anogenital warts,cervical cancer,qaly,daly

Data availability:

ScienceOpen disciplines: Health & Social care

Keywords: hpv, burden of disease, cin1, cin2–3, anogenital warts, cervical cancer, qaly, daly

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

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Most cited references 40

Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women

A controlled trial of a human papillomavirus type 16 vaccine.

Carcinoma of the cervix uteri. FIGO 26th Annual Report on the Results of Treatment in Gynecological Cancer.

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