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CDC HIV/AIDS/Viral Hepatitis/STD/TB Prevention News Update
CANADA: Adding Catch-Up Phase to HPV Vaccine Policy Could Save Lives and Money: Study
Helen Branswell
January 3, 2012
Canadian Press (12.21.11) - Tuesday, January 03, 2012

Since 2007, Ontario has offered free human papillomavirus vaccine to eighth-grade girls, but a new study suggests that adding a catch-up program for women ages 17-26 would result in additional cost savings and health gains. The study analyzed whether a catch-up HPV program for women missed by the school- based campaign made economic sense.

The school-based program uses Merck's Gardasil vaccine, which targets four HPV strains. The analysis presumed the older women would receive GlaxoSmithKline Cervarix, which protects against two HPV types responsible for most cervical cancer cases. Senior study author Chris Bauch, who is with the mathematics and statistics department at the University of Guelph in Ontario, said it appears the adjuvant-boosted Cervarix may be more effective in older women.

Annually, a catch-up program would save nearly $19 million (US $18.8 million) and 240 years of life for women who would not go on to die of cervical cancer, the study found. In conjunction with a catch-up program, the researchers also proposed delaying women's initial Pap smear from the currently recommended age of 18 to age 25. Delaying the exam would not jeopardize lives overall, the study suggests.

"Basically you're stopping a program that doesn't prevent a lot of cancer, (a) because there isn't a lot of cancer in younger ages and (b) because the screening is actually not very exact," Bauch said. "And you're taking the money you save on that relatively inefficient program and putting it into the vaccine, which can prevent more cancer more effectively than the screening program, according to the model." However, physicians often use the initial Pap visit to discuss other health services, such as birth control, Bauch said, so doctors would have to find other opportunities to offer these services.

The study, "Time for Change? An Economic Evaluation of Integrated Cervical Screening and HPV Immunization Programs in Canada," was published in Vaccine (2012;30(2):425-235).

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