Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, 1200 Pressler Street, Houston, TX, 77030, USA.
Department of Statistics, School of Mathematical and Statistics, Guangdong University of Foreign Studies, Xiaoguwei Street, Guangzhou, Guangdong, China.
Sci Rep. 2021 Jan 19;11(1):1802. doi: 10.1038/s41598-021-81375-5.
In 2017, 46,157 and 3,127 new oropharyngeal cancer (OPC) cases were reported in the U.S. and Texas, respectively. About 70% of OPC were attributed to human papillomavirus (HPV). However, only 51% of U.S. and 43.5% of Texas adolescents have completed the HPV vaccine series. Therefore, modeling the demographic dynamics and transmission of HPV and OPC progression is needed for accurate estimation of the economic and epidemiological impacts of HPV vaccine in a geographic area. An age-structured population dynamic model was developed for the U.S. state of Texas. With Texas-specific model parameters calibrated, this model described the dynamics of HPV-associated OPC in Texas. Parameters for the Year 2010 were used as the initial values, and the prediction for Year 2012 was compared with the real age-specific incidence rates in 23 age groups for model validation. The validated model was applied to predict 100-year age-adjusted incidence rates. The public health benefits of HPV vaccine uptake were evaluated by computer simulation. Compared with current vaccination program, increasing vaccine uptake rates by 50% would decrease the cumulative cases by 4403, within 100 years. The incremental cost-effectiveness ratio of this strategy was $94,518 per quality-adjusted life year (QALY) gained. Increasing the vaccine uptake rate by 50% can: (i) reduce the incidence rates of OPC among both males and females; (ii) improve the quality-adjusted life years for both males and females; (iii) be cost-effective and has the potential to provide tremendous public health benefits in Texas.
2017 年，美国和德克萨斯州分别报告了 46157 例和 3127 例新的口咽癌（OPC）病例。大约 70%的 OPC 归因于人乳头瘤病毒（HPV）。然而，只有 51%的美国青少年和 43.5%的德克萨斯州青少年完成了 HPV 疫苗系列接种。因此，需要对 HPV 和 OPC 进展的人口统计学动态和传播进行建模，以便在地理区域内准确估计 HPV 疫苗的经济和流行病学影响。为美国德克萨斯州开发了一个年龄结构人口动态模型。利用特定于德克萨斯州的模型参数进行校准，该模型描述了德克萨斯州 HPV 相关 OPC 的动态。将 2010 年的参数用作初始值，并将 2012 年的预测与 23 个年龄组的实际年龄特异性发病率进行比较，以验证模型。验证后的模型用于预测 100 年的年龄调整发病率。通过计算机模拟评估 HPV 疫苗接种的公共卫生效益。与当前的疫苗接种计划相比，将疫苗接种率提高 50%将在 100 年内减少 4403 例累计病例。该策略的增量成本效益比为每获得一个质量调整生命年（QALY）增加 94518 美元。提高疫苗接种率 50%可以：（i）降低男性和女性的 OPC 发病率；（ii）提高男性和女性的质量调整生命年；（iii）具有成本效益，并有可能在德克萨斯州带来巨大的公共卫生效益。
