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
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).