A map that integrates multiple data sources about HPV vaccination and cervical cancer burden in countries across the MENA region.
This volume represents one of the fundamental GICR Hub activities, which is to provide regional reports on cancer to complement IARC’s role in publishing international cancer incidence data in its Cancer Incidence in Five Continents (CI5) series. This volume brings together results from 25 cancer registries in 20 sub-Saharan African countries, from time periods ranging from 1 to 10 years within the past two decades. Not all of these results will be of sufficient quality (i.e. completeness and/or validity) to qualify for inclusion in CHAPTER 1 Introduction 2 Introduction the next volume of the CI5 series. However, because AFCRN membership requires that registries meet minimum criteria for completeness of case ascertainment (> 70% of the cases expected in the area must be registered), the results are undoubtedly a reasonable reflection of the true cancer profile in their respective populations. The individual registry presentations (Chapter 4, p. 13) include commentary on specific factors that should be taken into account in interpreting the observations.
This volume represents one of the fundamental GICR Hub activities, which is to provide regional reports on cancer to complement IARC’s role in publishing international cancer incidence data in its Cancer Incidence in Five Continents (CI5) series. This volume brings together results from 25 cancer registries in 20 sub-Saharan African countries, from time periods ranging from 1 to 10 years within the past two decades. Not all of these results will be of sufficient quality (i.e. completeness and/or validity) to qualify for inclusion in CHAPTER 1 Introduction 2 Introduction the next volume of the CI5 series. However, because AFCRN membership requires that registries meet minimum criteria for completeness of case ascertainment (> 70% of the cases expected in the area must be registered), the results are undoubtedly a reasonable reflection of the true cancer profile in their respective populations. The individual registry presentations (Chapter 4, p. 13) include commentary on specific factors that should be taken into account in interpreting the observations.
Background
The Arab states geographic region is marked by a low to moderate cervical cancer screening coverage rates and the absence of national human papillomavirus (HPV) vaccination programs, except for the United Arab Emirates. Knowing that the HPV prevalence among Tunisian woman is estimated to 4.9/100 000 according to the “HPV Center” data, this study aims to estimate the cost of a national cervical cancer prevention program in Tunisia using either the primary prevention method (the two-dose schedule anti-HPV vaccine according to the WHO recommendation for young adolescents) or the secondary prevention method (the Pap smear test according to three time-lapse periodicity).
Methods
The mean incremental cost of one avoided cervical cancer case was calculated for each prevention scenario.
Results
The ascending incremental costs by avoided cervical cancer case are: 1- the national vaccination program through the GAVI support ($ 1803), 2- the cervical cancer screening according to 10-year periodicity ($ 8219), 3- the cervical cancer screening according to 5-year periodicity ($ 14,567), 4- the cervical cancer screening according to 3-year periodicity ($ 20,479), 5- and finally the national vaccination program according to the manufacturer marketed price ($ 36,854).
Conclusion
Currently, the anti-HPV national vaccination program combined with cervical cancer screening according to 5-year periodicity present the best cost-effective strategy for cervical cancer prevention in Tunisia. This study gives Tunisian decision makers a basis for structured planning and cost apportionment to ensure effective roll-out of the cervical cancer prevention strategies.
Keywords
Cost-minimization
anti-HPV vaccine
Pap Smear test
Tunisia
Cervical cancer
Prevention