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: 8836495
• 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 2017-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8836495
• 关键词: Accounting; Adoption; Anus; Biological Markers; Biological Models; Calibration; Cancer Biology; Cancer Control; Cervical; Clinical; Clinical effectiveness; Cost Effectiveness Analysis; 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(申请人提供)：美国每年发生超过25,000例可归因于人类乳头瘤病毒(HPV)感染的浸润性癌症；近50%是宫颈癌，其余涉及口腔/口咽、肛门、外阴、阴茎和阴道。总体而言，这些导致了相当大的发病率和死亡率，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步，加上新技术(如HPV-16、HPV-18疫苗、HPV DNA检测)和新兴技术(如生物标记物、治疗性疫苗)，为改进癌症预防工作提供了难得的机会。然而，在临床决策和预防政策方面仍然存在关键挑战，涉及不同癌症自然历史中的知识差距和异质性、HPV-16、HPV-18疫苗接种后HPV类型分布的不确定性以及新兴技术的真实临床有效性。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的数据；评估替代战略的健康和经济后果；探索围绕其结果的不确定性；明确量化与不同方法相关的权衡；并及时提供临床和政策问题信息。通过实现我们的目标，我们预计将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战略的有效性；(4)与HPV相关的癌症结果，包括减少发病率、提高生活质量、改善生存率和缩小差异；以及(5)提供与癌症相关的健康服务的财务和经济状况。

项目成果

Cost-effective management of women with minor cervical lesions: Revisiting the application of HPV DNA testing.

对患有轻微宫颈病变的女性进行具有成本效益的管理：重新审视 HPV DNA 检测的应用。

• DOI: 10.1016/j.ygyno.2016.08.231
• 发表时间: 2016
• 期刊: Gynecologic oncology
• 影响因子: 4.7
• 作者: Pedersen,Kine;Burger,EmilyA;Sy,Stephen;Kristiansen,IvarS;Kim,JaneJ
• 通讯作者: Kim,JaneJ

Cost-effectiveness of surveillance strategies after treatment for high-grade anal dysplasia in high-risk patients.

高危患者重度肛门发育不良治疗后监测策略的成本效益。

• DOI: 10.1097/olq.0b013e31827f4fe9
• 发表时间: 2013
• 期刊: Sexually transmitted diseases
• 影响因子: 3.1
• 作者: Assoumou,SabrinaA;Mayer,KennethH;Panther,Lori;Linas,BenjaminP;Kim,Jane
• 通讯作者: Kim,Jane

Controlling HIV/AIDS: The Obstacles and Opportunities Ahead.

控制艾滋病毒/艾滋病：前方的障碍和机遇。

• 发表时间: 2013
• 期刊: JAMA internal medicine
• 影响因子: 39
• 作者: Steinbrook,Robert

Population-level impact, herd immunity, and elimination after human papillomavirus vaccination: a systematic review and meta-analysis of predictions from transmission-dynamic models.

• DOI: 10.1016/s2468-2667(16)30001-9
• 发表时间: 2016-11
• 期刊: The Lancet. Public health
• 作者: Brisson M;Bénard É;Drolet M;Bogaards JA;Baussano I;Vänskä S;Jit M;Boily MC;Smith MA;Berkhof J;Canfell K;Chesson HW;Burger EA;Choi YH;De Blasio BF;De Vlas SJ;Guzzetta G;Hontelez JAC;Horn J;Jepsen MR;Kim JJ;Lazzarato F;Matthijsse SM;Mikolajczyk R;Pavelyev A;Pillsbury M;Shafer LA;Tully SP;Turner HC;Usher C;Walsh C
• 通讯作者: Walsh C