人乳头瘤病毒(HPV)疫苗在宫颈癌预防中的有效性和成本效益

W. Chan, K. C. Cheung
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引用次数: 1

摘要

人乳头瘤病毒(HPV)感染是宫颈癌的主要原因。子宫颈癌患者要经历痛苦的长期治疗和高昂的医疗费用。预防胜于治疗。因此,建议香港妇女定期进行子宫颈普查,以预防这种疾病。在西方国家进行的一些研究表明,通过将HPV疫苗与定期筛查相结合,可以实现成本效益。该研究由三个研究小组指导,研究三种宫颈癌预防策略的成本效益的未来含义:(1)25-42岁女性每年进行子宫颈抹片检查,(2)12岁时接种HPV疫苗,(3)12岁时接种HPV疫苗并在25-42岁时进行每年的子宫颈抹片检查。比较三组的总寿命成本、成本效益比和预期寿命增量。采用马尔可夫模型软件作为主要分析工具。经分析,每年进行子宫颈抹片检查是一种具有成本效益的预防宫颈癌的方法,其终生总成本约为145.69美元;成本-效果比为8.80美元/年;预期寿命增加了2.72岁。此外,HPV疫苗接种结合每年的巴氏涂片筛查是延长女性预期寿命的有效方法,无论种族,终生总成本约为545.12美元;成本-效果比为29.56美元/年;预期寿命增加了2.84岁。这一结果为制定预防子宫颈癌的保健政策提供了重要的见解。这项政策可以挽救生命并降低当地治疗费用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Effectiveness and Cost-effectiveness of Human Papillomavirus (HPV) Vaccines in Cervical Cancer Prophylaxis
Human papillomavirus (HPV) infection is the main cause of cervical cancer. Cervical cancer patients go through painful long-term treatments and high medical costs. Prevention is better than cure. Hence, regular cervical screening is recommended for Hong Kong women to prevent this disease. Some studies have been conducted in Western countries to show that cost-effectiveness can be achieved by combining HPV vaccines with regular screening. The study is guided by three research groups on the future implication of the cost-effectiveness of three cervical cancer prevention strategies: (1) annual Pap smear for women aged 25–42, (2) HPV vaccination at age 12, and (3) HPV vaccination at age 12 combined with annual Pap smear screening at age 25–42. The three groups are compared in terms of their total lifetime cost, cost-effectiveness ratio and incremental life expectancy. The Markov model software is used as the main analytical tool. After analyzing, annual Pap smear screening is a cost-effective method to prevent cervical cancer that the total lifetime cost was approximately USD145.69; cost-effectiveness ratio was USD8.80/DALY; and incremental life expectancy was 2.72 years. Moreover, HPV vaccination combined with annual Pap smear screening is an effective way to prolong the life expectancy of women regardless of race that the total lifetime cost was approximately USD545.12; cost-effectiveness ratio was USD29.56/DALY; and incremental life expectancy was 2.84 years. Such result provides important insight for the formulation of a health care policy to prevent cervical cancer. This policy can save lives and reduce local treatment costs.
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