在加拿大安大略省部分接种疫苗的人群中优化宫查的危害和益处:一项建模研究
Daniël D de Bondt1, Erik E L Jansen1, Christine Stogios2
1Department of Public Health, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands.
概括
在安大略省优化宫癌查包括调整人类乳头瘤病毒 (HPV) 疫苗接种策略. 接种疫苗的人可能会从更少的终身查和延长的间隔中受益,从而改善危害-益处平衡.
科学领域:
- 妇科瘤学 妇科瘤学
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 在安大略省,首批接受了基于学校的人类乳头瘤病毒 (HPV) 疫苗接种的队伍现在有资格接受宫查.
- 确定最佳的宫部查策略至关重要,以平衡癌症预防的好处与查程序的危害.
研究的目的:
- 鉴于HPV疫苗接种状态,确定最佳的宫查策略,为安大略省人口提供最佳的危害益益比.
- 根据疫苗接种状况评估非分层和分层查协议.
主要方法:
- 使用STDSIM-MISCAN-Cervix混合微模拟模型来评估309种主要HPV查策略.
- 量化伤害作为HPV查和结肠镜转诊的加权组合,使用可接受度值.
- 进行了非分层 (统一的协议) 和分层 (疫苗接种状态依赖的协议) 分析.
主要成果:
- 对于非分层查,使用HPV16/18基因定型进行5次终身查,证明了最佳的危害/益处比率.
- 对于分层查,最佳策略是对接种疫苗的人进行3次终身查 (HPV16/18/31/33/45/52/58基因型) 和对未接种疫苗的人进行6次终身查 (HPV16/18基因型).
- 调整查强度和间隔可以改善危害-益处平衡,特别是在按疫苗接种状态分层时.
结论:
- 在安大略省,通过减少终身查次数和延长间隔,特别是对于接种疫苗的队列,可以实现最佳的宫查策略.
- 基于HPV疫苗接种状态的分层查协议可以进一步提高个人层面的危害-益处平衡.
- 该研究强调了通过考虑疫苗接种状况和使用联合危害措施来优化查计划的潜力.
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