将人类乳头瘤病毒疫苗添加到查计划中的潜在健康和经济影响
Shalini L Kulasingam1, Evan R Myers
1Department of Obstetrics and Gynecology and Center for Clinical Health Policy Research, Duke University, Durham, NC 27705, USA. kulas002@mc.duke.edu
JAMA
|August 14, 2003
概括
将人类乳头瘤病毒 (HPV) 疫苗接种与定期宫癌查相结合是具有成本效益的. 最佳策略取决于疫苗的疗效和HPV发病率高峰的年龄,这使得疫苗接种年龄成为一个关键的研究重点.
科学领域:
- 在瘤学瘤学.
- 疫苗学 疫苗学 疫苗学
- 公共卫生 公共卫生
背景情况:
- 人类乳头瘤病毒 (HPV) 的有效疫苗是导致子宫癌的原因,预计在未来十年内.
- 这项研究考察了HPV疫苗接种在现有的宫癌查计划中的整合.
研究的目的:
- 评估HPV疫苗接种与当前查实践一起对健康和经济的潜在影响.
- 确定预防宫癌的最具成本效益的策略.
主要方法:
- 一个马尔科夫模型模拟了美国一个假设的女性队列的终身成本和预期寿命.
- 进行比较的策略包括仅接种疫苗,仅查,接种疫苗后进行查.
- 分析了各种查间隔和开始年龄,包括针对高风险HPV类型的疫苗.
主要成果:
- 单独接种疫苗或不太频繁的查 (3-5年) 不具有成本效益.
- 将疫苗接种与更频繁的查 (每两年或每年一次) 结合起来,提高了成本效益.
- 从24岁开始进行两年一次查的疫苗接种提供了有利的比率 (44,889美元/生命年获得).
- 从18岁开始每年进行查的疫苗接种使得癌症发病率和死亡率减少最多 (每年获得的236,250美元).
结论:
- 将HPV疫苗接种与子宫癌查相结合是一个具有成本效益的方法.
- 疫苗的有效性取决于在HPV发病率高峰时期的持续疫苗有效性.
- 优先考虑对最佳疫苗接种年龄的研究对于最大化益处至关重要.
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