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Study Explores Health Benefits and Cost-Effectiveness of HPV Vaccinations and Screening Strategies
The most cost-effective strategy for human papillomavirus (HPV) vaccination
and screening would initiate vaccinations at age 12, followed by cytology screening for HPV every 3 years beginning at age 25, according to the results of a new computer-based modeling study. This approach would reduce mortality due to cervical
cancer by 94 percent compared with no intervention at all, concluded the study's authors, Dr. Sue J. Goldie from the Harvard School of Public Health and colleagues, in the April 21
Journal of the National Cancer Institute.
In the study, the cost-effectiveness of various vaccination strategies for two of the most oncogenic HPV strains (16 and 18) and screening - alone and in combination - were examined. All vaccinations were begun at 12 years of age; screenings began at 18, 21, 25, 30, or 35 years of age, with screening intervals ranging from 1 to 5 years. The researchers modeled varying effectiveness
of the vaccines ranging
from 70 percent to 100 percent. The next most cost-effective strategy, which
resulted in an 89.7 percent reduction in mortality, involved a combination of vaccination with screening every
5 years beginning at age 21.
Vaccination at 12 years of age would allow for a later age of screening initiation and less frequent screening intervals than are currently recommended,
the authors concluded. Under
current U.S. Preventive Services Task
Force recommendations, a woman should begin cervical cancer screening
3 years after she begins having sexual intercourse, but no later than age 21;
subsequently women should be screened at least once every 3 years.
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A Model for Addressing Health Care Disparities
In late March, the trans-HHS Cancer Health Disparities Progress Review Group (PRG) released its report, Making
Cancer Health Disparities History.
The report includes recommendations
to the U.S. Department of Health and Human Services (HHS) intended to significantly reduce cancer health disparities in the United States.
Last week I had the honor of officially presenting the PRG's final report to the
recently formed HHS Health Disparities
Council. The council, which is charged
with establishing a coordinated, HHS-wide approach to battling health care disparities, will review the report and decide which recommendations
can and should be pursued.
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This NCI Cancer Bulletin is produced by the National Cancer Institute (NCI). NCI, which was established in 1937, leads a national effort to eliminate the suffering and death due to cancer. Through basic and clinical biomedical research and training, NCI conducts and supports research that will lead to a future in which we can prevent cancer before it starts, identify cancers that do develop at the earliest stage, eliminate cancers through innovative treatment interventions, and biologically control those cancers that we cannot eliminate so they become manageable, chronic diseases.
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For more information on cancer,
call 1-800-4-CANCER or visit
http://cancer.gov.
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NCI Cancer Bulletin staff can be reached at ncicancerbulletin@mail.nih.gov.
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