Sabale Ugne, Reuschenbach Miriam, Takyar Jitender, Dhawan Arju, Hall Adam, Vittal D, Saggu Gurkiran, Ghelardi Alessandro, Del Pino Marta, Nowakowski Andrzej, Valente Stefano
Value & Implementation Outcomes Research, MSD, Vilnius, Lithuania.
Global Medical and Scientific Affairs, MSD Sharp & Dohme GmbH, Munich, Germany.
Eur J Obstet Gynecol Reprod Biol X. 2024 Dec 12;25:100360. doi: 10.1016/j.eurox.2024.100360. eCollection 2025 Mar.
High-grade cervical intraepithelial neoplasia (CIN) is a premalignant lesion of the cervix caused by persistent human papillomavirus (HPV) infection, which can lead to cervical cancer. Despite ongoing primary prevention efforts, considerable burden of illness remains. This study assessed the epidemiological, economic, and humanistic burden associated with high-grade CIN among adult women in Europe.
Systematic literature reviews (SLRs) were conducted for epidemiological, economic, and humanistic burden, in adult women with high-grade CIN in the broader European region. Search strategies were aligned to Cochrane and PRISMA guidelines. Databases searched included Medline®, Embase®, and Cochrane databases (2012-2022). Conference proceedings were also searched (2018-2022). Outcomes of interest included incidence, prevalence, HPV genotype, cost burden, resource use and quality of life burden.
Evidence from 41 epidemiological, 11 economic burden, and 8 humanistic burden studies was included. Incidence of high-grade CIN was 31-186/100,000 women-years in a screened population, with prevalence rates of 0.1-2.2 %. Incidence and prevalence of high-grade CIN peaked among women aged 25-39 years. In women with high-grade CIN, high-risk genotypes were among those most commonly identified, including HPV16/18 (57.0-58.7 %), HPV16 (47.4-52.0 %), HPV18 (4.0-15.0 %) and HPV 31/33/45 (38 %). Cost burden and healthcare resource utilization was higher for CIN3 vs. CIN2. High-grade CIN significantly impaired quality of life, across multiple domains vs. healthy population.
High-grade CIN was associated with considerable burden in Europe. These findings reveal the multifaceted nature of the impact incurred by women with high-grade CIN, and highlight some of the key areas of unmet need among this patient population.
高级别宫颈上皮内瘤变（CIN）是由持续性人乳头瘤病毒（HPV）感染引起的子宫颈癌前病变，可导致宫颈癌。尽管一直在进行一级预防工作，但疾病负担仍然相当大。本研究评估了欧洲成年女性中与高级别CIN相关的流行病学、经济和人文负担。
对欧洲更广泛地区成年高级别CIN女性的流行病学、经济和人文负担进行了系统文献综述（SLR）。检索策略符合Cochrane和PRISMA指南。检索的数据库包括Medline®、Embase®和Cochrane数据库（2012 - 2022年）。还检索了会议论文集（2018 - 2022年）。感兴趣的结果包括发病率、患病率、HPV基因型、成本负担、资源使用和生活质量负担。
纳入了41项流行病学研究、11项经济负担研究和8项人文负担研究的证据。在筛查人群中，高级别CIN的发病率为每100,000妇女年31 - 186例，患病率为0.1% - 2.2%。高级别CIN的发病率和患病率在25 - 39岁女性中达到峰值。在高级别CIN女性中，高危基因型是最常鉴定出的基因型之一，包括HPV16/18（57.0% - 58.7%）、HPV16（47.4% - 52.0%）、HPV18（4.0% - 15.0%）和HPV 31/33/45（38%）。CIN3的成本负担和医疗资源利用率高于CIN2。与健康人群相比，高级别CIN在多个领域显著损害了生活质量。
在欧洲，高级别CIN与相当大的负担相关。这些发现揭示了高级别CIN女性所受影响的多方面性质，并突出了该患者群体中一些未满足需求的关键领域。
