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Cost Effectiveness of New Cervical Cancer Prevention VaccineSince a study published in the November 2002 issue of the New England Journal of Medicine reported promising results of a vaccine for certain types of human papillomavirus (HPV) that cause cervical cancer, there has been debate about how current cervical cancer screening recommendations will be affected. Though the vaccine still remains in clinical trial phase, researchers at Duke University Medical Center analyzed the cost effectiveness of different prevention strategies involving the vaccine and the traditional Pap test. They concluded that the vaccine and Pap test should be used in combination. Shalini Kulasingam, Ph.D., lead author and research associate in the department of obstetrics and gynecology at the Duke University Medical Center, said, "There are many high risk types of HPV. The vaccines in development target the most common types that cause cervical cancer, but they do not protect against all high-risk types. Screening will still be needed even after an effective vaccine is commercially available, but then will it be cost-effective to leave our current policy recommendations unchanged?" Duke researchers used a mathematical model to estimate the lifetime costs and life expectancy of three approaches: 1) the vaccine alone, 2) conventional screening alone, and 3) vaccination followed by screening. They reported that the third approach (vaccination with biennial screening commencing at the age of 24) would be the most effective strategy. Other options were deemed too expensive or insufficient in preventing disease. The current screening recommendation is an annual Pap test, beginning three years after first sexual intercourse or age 21, whichever comes first. The Duke analysis was published in the August 13, 2003 issue of the Journal of the American Medical Association. Cervical cancer is widespread in America, affecting approximately 12,200 women this year, according to estimates by the American Cancer Society.
October 4, 2003 | |||||
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