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: 8627587
• 负责人: JANE JOOYUN KIM
• 金额: $ 29.89万
• 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/8627587
• 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.

描述（由申请人提供）：美国每年发生超过 25,000 例由人乳头瘤病毒 (HPV) 感染引起的浸润性癌症病例；近50%是宫颈癌，其余则涉及口腔/口咽、肛门、外阴、阴茎和阴道。总的来说，这些因素导致了很高的发病率和死亡率，造成了健康差异，并带来了高昂的经济成本。 HPV 相关癌症流行病学的进步，加上新的（例如 HPV-16、-18 疫苗、HPV DNA 检测）和新兴技术（例如生物标志物、治疗性疫苗），为改善癌症预防工作提供了绝佳的机会。然而，临床决策和预防政策方面仍然存在关键挑战，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，开发灵活的建模框架，使我们能够综合最佳的可用数据；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 (1) 决策科学的分析方法产生影响； （二）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策略的有效性； (4) HPV相关的癌症结果，包括降低发病率、提高生活质量、提高生存率和缩小差异； (5) 提供癌症相关卫生服务的财务和经济状况。