Comparative and Cost-Effectiveness of Preventing HPV-Related Diseases

预防 HPV 相关疾病的比较和成本效益

• 批准号: 8245277
• 负责人: JANE JOOYUN KIM
• 金额: $ 30.81万
• 依托单位: HARVARD SCHOOL OF PUBLIC HEALTH
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-06-01 至 2016-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8245277
• 关键词: Accounting; Adoption; Anus; Biological Markers; Biological Models; Calibration; Cancer Biology; Cancer Control; Cervical; Clinical; Clinical effectiveness; Coupled; DNA; Data; Development; Disease; Disease Progression; Disease model; Economic Burden; Economics; Effectiveness; Effectiveness of Interventions; Emerging Technologies; Epidemiology; Evaluation; Guidelines; Health; Health Services; Heterogeneity; Human Papilloma Virus Vaccine; Human Papillomavirus; Human papilloma virus infection; Human papillomavirus 16; Incidence; Intervention; Investigation; Knowledge; Malignant Neoplasms; Malignant neoplasm of anus; Malignant neoplasm of cervix uteri; Malignant neoplasm of penis; Medical Technology; Methods; Modeling; Morbidity - disease rate; Natural History; Nature; Oncogenic; Oral cavity; Oropharyngeal; Outcome; Policies; Policy Analysis; Policy Maker; Population Attributable Risks; Premalignant; Prevention; Prevention strategy; Preventive; Primary Prevention; Public Health; Publishing; Quality of life; Reporting; Rest; Risk; Risk Factors; Science; Secondary Prevention; Series; Structure; Subgroup; Technology; Testing; Translations; Uncertainty; United States; Vaccination; Vagina; Validation; Vulva; Woman; base; cancer epidemiology; cancer health disparity; cancer prevention; carcinogenesis; clinical decision-making; clinically relevant; comparative; comparative effectiveness; cost; cost effectiveness; economic cost; flexibility; health disparity; health economics; improved; insight; interest; men; models and simulation; mortality; new technology; next generation; novel strategies; penis; population health; prevent; racial and ethnic disparities; therapeutic vaccine; tool; transmission process; virology

DESCRIPTION (provided by applicant): Each year, more than 25,000 cases of invasive cancer attributable to human papillomavirus (HPV) infection occur in the United States; nearly 50% are cervical cancer, while the rest involve the oral cavity/oropharynx, anus, vulva, penis, and vagina. Collectively, these account for substantial morbidity and mortality, contribute to health disparities, and are associated with high economic costs. Advancements in HPV-related cancer epidemiology, coupled with new (e.g., HPV-16,-18 vaccines, HPV DNA testing) and emerging (e.g., biomarkers, therapeutic vaccines) technologies provide a remarkable opportunity to improve cancer prevention efforts. However, critical challenges remain with respect to clinical decision-making and prevention policy, pertaining to knowledge gaps and heterogeneities in the natural history of different cancers, uncertainties in HPV type distribution following HPV-16,-18 vaccination, and the real-world clinical effectiveness of emerging technologies. We propose to employ a decision-analytic approach, developing a flexible modeling framework that will allow us to synthesize the best available data; evaluate the health and economic consequences of alternative strategies; explore the uncertainty around their outcomes; explicitly quantify the tradeoffs associated with different approaches; and inform timely clinical and policy questions. By achieving our aims, we expect to have an impact on (1) the analytic methods of decision science; (2) the equitable distribution and rationale use of new technology; (3) the effectiveness of strategies for cancer prevention through clinical guidelines and national policies; (4) HPV-related cancer outcomes, including reduced incidence, enhanced quality of life, improved survival, and reduced disparities; and (5) the financial and economic profile of delivering cancer-related health services. PUBLIC HEALTH RELEVANCE: Rapid advances in the fields of HPV-related cancer epidemiology and medical technology present opportunities to revolutionize the approach to cancer prevention in the U.S. but have outpaced the ability of policy makers to make informed decisions regarding optimal adoption of health interventions. In this project, we propose to develop a flexible modeling framework that will enable us to synthesize the best available data on HPV, provide insight into the comparative and cost-effectiveness of different strategies, and assist in informed public health and clinical decision-making with respect to prevention of HPV-related cancers.

描述（申请人提供）：美国每年发生超过25，000例因人乳头瘤病毒（HPV）感染而导致的浸润性癌症病例;近50%是宫颈癌，其余涉及口腔/口咽、肛门、外阴、阴茎和阴道。总的来说，这些因素造成了很高的发病率和死亡率，造成了健康差距，并与高昂的经济成本有关。HPV相关癌症流行病学的进展，加上新的（例如，HPV-16，-18疫苗，HPV DNA检测）和新兴（例如，生物标志物、治疗性疫苗）技术为改善癌症预防工作提供了显著的机会。然而，在临床决策和预防政策方面仍然存在重大挑战，涉及不同癌症自然史的知识差距和异质性，HPV-16，-18疫苗接种后HPV类型分布的不确定性以及新兴技术的实际临床有效性。我们建议采用决策分析方法，开发一个灵活的建模框架，使我们能够综合最佳可用数据;评估替代策略的健康和经济后果;探索其结果的不确定性;明确量化与不同方法相关的权衡;并及时告知临床和政策问题。通过实现我们的目标，我们期望对以下方面产生影响：（1）决策科学的分析方法;（2）新技术的公平分配和合理使用;（3）通过临床指南和国家政策预防癌症的策略的有效性;（4）HPV相关癌症的结果，包括降低发病率，提高生活质量，改善生存率，减少差异;以及（5）提供癌症相关卫生服务的财政和经济状况。 公共卫生关系：HPV相关癌症流行病学和医疗技术领域的快速发展为美国癌症预防方法的革命提供了机会，但已经超过了政策制定者就最佳采用健康干预措施做出明智决策的能力。在这个项目中，我们建议开发一个灵活的建模框架，使我们能够综合关于HPV的最佳可用数据，深入了解不同策略的比较和成本效益，并协助在预防HPV相关癌症方面做出明智的公共卫生和临床决策。