Effects of updated demography, disability weights, and cervical cancer burden on estimates of human papillomavirus vaccination impact at the global, regional, and national levels: a PRIME modelling study
Effects of updated demography, disability weights, and cervical cancer burden on estimates of human papillomavirus vaccination impact at the global, regional, and national levels: a PRIME modelling study
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DOI：
10.1016/s2214-109x(20)30022-x
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发表时间：
2020-04-01
影响因子：
34.3
通讯作者：
Jit, Mark
中科院分区：
文献类型：
--
作者：
Abbas, Kaja M.;van Zandvoort, Kevin;Jit, Mark
乳头瘤病毒建模和经济学快速界面（PRIME）已在世界各地用于评估女孩接种人乳头瘤病毒（HPV）疫苗的健康影响和成本效益。我们使用人口统计学、残疾权重和宫颈癌负担的新数据和方法更新了PRIME，并对177个国家在全球、区域和国家层面HPV疫苗接种的健康影响进行了修订估计。方法PRIME使用联合国世界人口展望（UNWPP）2019年修订版的人口统计学进行了更新，全球疾病负担（GBD）2017研究的残疾权重，以及全球癌症发病率，死亡率和患病率（GLOBOCAN）2018数据库的宫颈癌负担。我们估计，在2020- 2029年期间，177个国家的9岁和12岁女孩接种二价或四价和九价疫苗的终身健康益处为90%。健康影响以每1000名接种疫苗的女孩避免的宫颈癌病例，死亡或残疾调整生命年（DALY）与未接种疫苗的反事实情景相比，以及需要接种疫苗以防止单一病例，死亡或DALY.Findings的女孩数量估计HPV疫苗接种对9岁女孩的健康影响，人口统计学的综合更新，残疾权重、宫颈癌负担估计值导致每1000名接种二价或四价和九价疫苗的女孩避免的病例估计数增加26%，避免的死亡增加51%，避免的DADs增加72%。根据更新的模型，估计二价或四价HPV疫苗每1000名接种女孩可避免15例病例，12例死亡和243例死亡，而九价HPV疫苗估计每1000名接种女孩可避免19例病例，14例死亡和306例死亡。12岁女孩接种疫苗的健康益处估计与9岁女孩接种疫苗相似，但略有下降。解释HPV疫苗接种提供了更大的健康益处，比以前估计的更具成本效益。纳入人口老龄化的最新人口统计数据对健康影响估计数的影响最大。世卫组织非洲区域有望获得最大的健康益处，应优先接种HPV疫苗。版权所有（c）2020作者。由Elsevier Ltd.出版。这是一篇开放获取文章，使用CC BY 4.0许可证。
Background The Papillomavirus Rapid Interface for Modelling and Economics (PRIME) has been used around the world to assess the health impact and cost-effectiveness of human papillomavirus (HPV) vaccination in girls. We updated PRIME with new data and methods for demography, disability weights, and cervical cancer burden, and generated revised estimates of the health impact of HPV vaccination at the global, regional, and national levels for 177 countries.Methods PRIME was updated with population demography of the UN World Population Prospects (UNWPP) 2019 revision, disability weights of the Global Burden of Disease (GBD) 2017 study, and cervical cancer burden from the Global Cancer Incidence, Mortality and Prevalence (GLOBOCAN) 2018 database. We estimated the lifetime health benefits for bivalent or quadrivalent and nonavalent vaccination of 9-year-old and 12-year-old girls at 90% coverage during 2020-29 in 177 countries. Health impact was presented in terms of cervical cancer cases, deaths, or disability-adjusted life-years (DALYs) averted per 1000 vaccinated girls in comparison with the counterfactual scenario of no vaccination, and the number of girls needed to be vaccinated to prevent a single case, death, or DALY.Findings In estimating the health impact of HPV vaccination of 9-year-old girls, the combined updates to demography, disability weights, cervical cancer burden estimates resulted in a 26% increase in the estimated number of cases averted, a 51% increase in deaths averted, and a 72% increase in DALYs averted per 1000 vaccinated girls for both the bivalent or quadrivalent and nonavalent vaccines, compared with previous estimates. With the updated model, the bivalent or quadrivalent HPV vaccine was estimated to avert 15 cases, 12 deaths, and 243 DALYs per 1000 vaccinated girls, and the nonavalent HPV vaccine was estimated to avert 19 cases, 14 deaths, and 306 DALYs per 1000 vaccinated girls. The health benefits of vaccination of 12-year-old girls were estimated to be similar but slightly decreased in comparison with vaccination of 9-year-old girls.Interpretation HPV vaccination provides greater health benefits and is more cost-effective than was previously estimated. The demography update, which incorporates population aging, has the largest effect on the health impact estimates. The WHO African region is expected to gain the greatest health benefits and should be prioritised for HPV vaccination. Copyright (c) 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license.