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Clinical and economic aspects of using vaccinating against HPV

Maciej Niewada1,2, Michał Jakubczyk1,3, Tomasz Macioch1, Katarzyna Graczyk1, Joanna Lasocka1, Waldemar Wierzba4, Stanisław Radowicki5

Affiliacja i adres do korespondencji
CURR. GYNECOL. ONCOL. 2013, 11 (2), p. 137–150
DOI: 10.15557/CGO.2013.0013
Streszczenie

Cervical cancer is one of the most common types of cancer in women population in the world and is the cause of majority of deaths among women. Poland is one of the countries with the highest morbidity which is about 3000 cases yearly; major group – of 1301 cases – constitute women aged 45–54. According to National Cancer Registry in years 1999–2010 morbidity and mortality due to cervical cancer remain stable. Key factor leading to cervical cancer is infection with oncogenic types of human papillomavirus (HPV). The most significant are types HPV-16 and HPV-18 which are estimated to be responsible for 73% of cases. Low-oncogenic types HPV-6 and HPV-11 are major cause of warts in areas of cervix, vulva and anus. Vaccinations against HPV represent one of the components of primary prevention. Vaccinations should be supplemented with public education activities focusing on cervical cancer and HPV infections. Secondary prevention should involve regular screening tests among women aged 21–25. Currently two vaccines are registered in Poland: quadrivalent Silgard® against HPV-6, HPV-11, HPV-16 and HPV-18 and bivalent Cervarix® against HPV-16 and HPV-18. Analyses conducted in various countries reported cost-effectiveness of strategies based on vaccinations against HPV infections conducted along with screening tests over strategy based only on screening tests. In Polish settings cost per additional QALY (quality-adjusted life year) in case of vaccinations with Silgard® was estimated for 12 704 PLN. The value is 9 times lower than the official cost-effectiveness threshold of medical technologies in Poland which equals 105 801 PLN/QALY and indicates cost-effectiveness of using and funding quadrivalent vaccine Silgard® in Polish settings.

Słowa kluczowe
infections, HPV, vaccines, cost-effectiveness, cervical cancer