The health and economic impact of scaling cervical cancer prevention in 50 low- and lower-middle-income countries.

摘要: Objective To estimate the health impact, financial costs, and cost-effectiveness of scaling-up coverage human papillomavirus (HPV) vaccination (young girls) cervical cancer screening (women age) for women in countries that will likely need donor assistance. Methods We used a model-based approach to synthesize population, demographic, epidemiological data from 50 low- lower-middle-income countries. Models were project costs (US $), lifetime impact (cervical cases, deaths averted), (US $ per disability adjusted life year [DALY] averted) of: (1) two-dose HPV-16/18 girls aged 10 years; (2) once-in-a-lifetime screening, with treatment when needed, 35 years either HPV DNA testing or visual inspection acetic acid (VIA); (3) over 10-year roll-out. Results We estimated both would be very cost-effective, comprehensive program could avert 5.2 million 3.7 deaths, 22.0 DALYs lifetimes intervention cohorts total cost US $3.2 billion. Conclusion Investment young screen-and-treat programs substantial burden disease while providing good value public dollars.