Health and economic impact of HPV vaccination and cervical cancer screening in Eastern Africa
In an upcoming issue of the International Journal of Cancer, former- and current CHDS researchers developed models of HPV-related infection and cervical cancer by utilizing epidemiologic data from five Eastern African countries (Kenya, Mozambique, Tanzania, Uganda and Zimbabwe), to measure the health and economic impact of HPV vaccination in pre-adolescent girls and screening in adult women. Results showed that vaccination alone could reduce the lifetime cancer risk by between 36 and 45% across the five countries, and the addition of screening at age 35 would lead to a reduction of 43% to 51%. The analyses also showed that cost per vaccinated girl was the most significant driver of the cost-effectiveness of potential interventions. If the cost per girl was less than I$2 per dose, vaccination was the most cost-effective strategy and had an incremental cost-effectiveness ratio in each setting less than the country-specific per capita GDP. If the cost per vaccinated girl was between I$2 and I$5 per dose, vaccination followed by screening at age 35 with one-visit HPV DNA testing would also be considered good value for public health dollars. The analysis demonstrates the importance of making informed decisions on the appropriate use of HPV vaccine and screening in developing countries, and the benefits these technologies could provide.