Evidence map›Paper›PMID 28720082›Full record

ArticleBMC infectious diseases2017

Cost-effectiveness analysis of different types of human papillomavirus vaccination combined with a cervical cancer screening program in mainland China.

Xiuting Mo, Ruoyan Gai Tobe, Lijie Wang, Xianchen Liu, Bin Wu, Huiwen Luo, Chie Nagata, Rintaro Mori, Takeo Nakayama

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC infectious diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 5 pooled it
2.8field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

37 citing papers in PubMed, 5 syntheses or guidelines pooled it, 45 citations in OpenAlex.

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  10. Cost-benefit analysis of p16Infectious agents and cancer · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 3 countries.

Xiuting MoDepartment of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
Ruoyan Gai TobeDepartment of Health Policy, National Center for Child Health and Development, Okura 2-10-1, Setagaya-ku, Tokyo, 157-8535, Japan. gai-r@ncchd.go.jp.
Lijie WangDepartment of Gynecology, Qilu Hospital of Shandong University, Jinan, China.
Xianchen LiuCollege of Pharmacy, The University of Tennessee Health Science Center, Memphis, TN, USA.
Bin WuMedical Decision and Economic Group, Department of Pharmacy, Ren Ji Hospital affiliated with Medical School of Shanghai Jiao tong University, Shanghai, China.
Huiwen LuoNanjing Drum Tower Hospital affiliated Medical School of Nanjing University, Nanjing, China.
Chie NagataDepartment of Education for Clinical Research, National Centre for Child Health and Development, Tokyo, Japan.
Rintaro MoriDepartment of Health Policy, National Center for Child Health and Development, Okura 2-10-1, Setagaya-ku, Tokyo, 157-8535, Japan.
Takeo NakayamaDepartment of Health Informatics, Kyoto University School of Public Health, Kyoto, Japan.
National Center For Child Health and Development · JPKyoto University · JPNanjing Drum Tower Hospital · CNQilu Hospital of Shandong University · CNShanghai Jiao Tong University · CNUniversity of Tennessee Health Science Center · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundChina has a high prevalence of human papillomavirus (HPV) and a consequently high burden of disease with respect to cervical cancer. The HPV vaccine has proved to be effective in preventing cervical cancer and is now a part of routine immunization programs worldwide. It has also proved to be cost effective. This study aimed to assess the cost-effectiveness of 2-, 4-, and 9-valent HPV vaccines (hereafter, HPV2, 4 or 9) combined with current screening strategies in China.

methodsA Markov model was developed for a cohort of 100,000 HPV-free girls to simulate the natural history to HPV infection. Three recommended screening methods (1. liquid-based cytology test + HPV DNA test; 2. pap smear cytology test + HPV DNA test; 3. visual inspection with acetic acid) and three types of HPV vaccination program (HPV2/4/9) were incorporated into 15 intervention options, and the incremental cost-effectiveness ratio (ICER) was calculated to determine the dominant strategies. Costs, transition probabilities and utilities were obtained from a review of the literature and national databases. One-way sensitivity analyses and threshold analyses were performed for key variables in different vaccination scenarios.

resultsHPV9 combined with screening showed the highest health impact in terms of reducing HPV-related diseases and increasing the number of quality-adjusted life years (QALYs). Under the current thresholds of willingness to pay (WTP, 3 times the per capita GDP or USD$ 23,880), HPV4/9 proved highly cost effective, while HPV2 combined with screening cost more and was less cost effective. Only when screening coverage increased to 60% ~ 70% did the HPV2 and screening combination strategy become economically feasible.

conclusionsThe combination of the HPV4/9 vaccine with current screening strategies for adolescent girls was highly cost-effective and had a significant impact on reducing the HPV infection-related disease burden in Mainland China.

Indexed as

AdolescentChildChinaCohort StudiesCost-Benefit AnalysisFemaleHumansMarkov ChainsMass ScreeningPapanicolaou TestPapillomaviridaePapillomavirus InfectionsPapillomavirus VaccinesQuality-Adjusted Life YearsUterine Cervical NeoplasmsVaccinationPapillomavirus VaccinesCervical cancerCervical intraepithelial neoplasiaIncremental cost-effectiveness ratioVaccine

Identifiers

PMID28720082
PMCPMC5516327
OpenAlexW2739460131

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.