Direct benefit of vaccinating boys along with girls against oncogenic human papillomavirus: bayesian evidence synthesis

BMJ, 12 May 2015

This paper aims to assess the reduction in the vaccine preventable burden of cancer in men if boys are vaccinated along with girls against oncogenic human papillomavirus (HPV) using a Bayesian evidence synthesis approach to evaluate the impact of vaccination against HPV types 16 and 18 on the burden of anal, penile, and oropharyngeal carcinomas among heterosexual men and men who have sex with men.

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Comparison of two dose and three dose human papillomavirus vaccine schedules: cost effectiveness analysis based on transmission model

BMJ, 7 January 2015

This study investigates the incremental cost effectiveness of two dose human papillomavirus vaccination and of additionally giving a third dose.

The results show that giving at least two doses of vaccine seems to be highly cost effective across the entire range of scenarios considered at the quadrivalent vaccine list price of £86.50 (€109.23; $136.00) per dose. If two doses give only 10 years’ protection but adding a third dose extends this to lifetime protection, then the third dose also seems to be cost effective at £86.50 per dose (median incremental cost effectiveness ratio £17 000, interquartile range £11 700-£25 800). If two doses protect for more than 20 years, then the third dose will have to be priced substantially lower (median threshold price £31, interquartile range £28-£35) to be cost effective. Results are similar for a bivalent vaccine priced at £80.50 per dose and when the same scenarios are explored by parameterising a Canadian model (HPV-ADVISE) with economic data from the United Kingdom.

The study concludes that two dose human papillomavirus vaccine schedules are likely to be the most cost effective option provided protection lasts for at least 20 years. As the precise duration of two dose schedules may not be known for decades, cohorts given two doses should be closely monitored.

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Accuracy of urinary human papillomavirus testing for presence of cervical HPV: systematic review and meta-analysis

British Medical Journal, 16 September 2014

A systematic review and meta-analysis to determine the accuracy of testing for human papillomavirus (HPV) DNA in urine in detecting cervical HPV in sexually active women.  The paper concludes that testing urine for HPV seems to have good accuracy for the detection of cervical HPV, and testing first void urine samples is more accurate than random or midstream sampling. When cervical HPV detection is considered difficult in particular subgroups, urine testing should be regarded as an acceptable alternative.

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