Jit Mark, Prem Kiesha, Benard Elodie, Brisson Marc
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; School of Public Health, University of Hong Kong, Patrick Manson Building, 7 Sassoon Road, Hong Kong SAR, China.
Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, Keppel Street, London WC1E 7HT, United Kingdom; Saw Swee Hock School of Public Health, National University of Singapore, 12 Science Drive 2, #10-01, 117549, Singapore.
Prev Med. 2021 Mar;144:106354. doi: 10.1016/j.ypmed.2020.106354. Epub 2020 Dec 10.
The Director-General of the World Health Organization has called for global action towards elimination of cervical cancer as a public health problem. Cervical cancer is caused by human papillomavirus (HPV), an infectious agent with no non-human reservoir. One way to achieve this is through very high levels of vaccine coverage that could enable global eradication of vaccine-type HPV. Using the case study of India, we show that HPV eradication can meet all the Dahlem and Strüngmann criteria for feasibility of eradication. It can be achieved with 90% gender-neutral HPV vaccine coverage together with 95% coverage in high-risk groups such as female sex workers. Such a strategy would likely be cost-effective compared to no vaccination. Although it would be more costly in the short-term than achieving cervical cancer elimination alone, it would save costs in the long-term by removing or at least sharply reducing the need for preventive measures.
世界卫生组织总干事呼吁采取全球行动，将宫颈癌作为一个公共卫生问题予以消除。宫颈癌由人乳头瘤病毒（HPV）引起，这是一种没有非人类宿主的传染源。实现这一目标的一种方法是通过极高的疫苗接种覆盖率，从而能够在全球根除疫苗型HPV。通过印度的案例研究，我们表明HPV根除可以满足达勒姆和施特伦曼提出的根除可行性的所有标准。在性别中立的人群中实现90%的HPV疫苗接种覆盖率，同时在女性性工作者等高风险群体中实现95%的覆盖率，就可以实现这一目标。与不接种疫苗相比，这样的策略可能具有成本效益。尽管从短期来看，这比单独消除宫颈癌的成本更高，但从长期来看，通过消除或至少大幅减少预防措施的需求，它将节省成本。
