State-level disparities in cervical cancer prevention and impact on outcomes in the U.S.: A modeling study

Author:

Alarid-Escudero FernandoORCID,Gracia ValeriaORCID,Wolf MarinaORCID,Zhao Ran,Easterly Caleb W.ORCID,Kim Jane J.,Canfell KarenORCID,de Kok Inge M.C.M.ORCID,Barnabas Ruanne V.ORCID,Kulasingam ShaliniORCID

Abstract

AbstractBackgroundDespite the availability of HPV vaccines for over a decade, coverage across the United States (US) is varied. While some states have made concerted efforts to increase HPV vaccination coverage, most model-based analyses have estimated vaccine impact on the US. We estimated the impact of hypothetical changes in HPV vaccination coverage at the state level for three states with varying levels of HPV vaccination coverage and cervical cancer incidence (California, New York, Texas) using a mathematical model.MethodsWe developed a new mathematical model of HPV transmission and cervical cancer tailored to state-level cancer incidence and mortality. We quantified the public health impact of increasing HPV vaccination coverage to 80% by 2025 or 2030 and the effect on time to elimination in the three states.ResultsIncreasing vaccination coverage to 80% in Texas in 10 years could reduce cervical cancer incidence by 50.9% (95%-CrI: 46.6-56.1%) by 2100. In New York and California, achieving the same coverage could reduce incidence by 27.3% (95%-CrI: 23.9-31.5%) and 24.4% (95%-CrI: 20.0-30.0%), respectively. Achieving 80% coverage in 5 years will slightly increase the reduction. If 2019 vaccination coverage continues, cervical cancer elimination would be reached in the US by 2051 (95%-Crl: 2034-2064). However, the timeline by which individual states reach elimination could vary by decades.ConclusionAchieving an HPV vaccination coverage target of 80% by 2030 will benefit states with low vaccination coverage and high cervical cancer incidence the most. Our results highlight the value of more geographically focused analyses to inform priorities.

Publisher

Cold Spring Harbor Laboratory

Reference34 articles.

1. International Agency for Research on Cancer (IARC). Cervical Cancer Screening. Vol 18.; 2022. https://publications.iarc.fr/604

2. Human papillomavirus vaccination for adults aged 30 to 45 years in the United States: A cost-effectiveness analysis

3. Projected time to elimination of cervical cancer in the USA: a comparative modelling study

4. World Health Organization. Cervical Cancer Elimination Initiative. WHO. Published 2023. Accessed February 28, 2023. https://www.who.int/initiatives/cervical-cancer-elimination-initiative

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