Introducing HPV Vaccine in Developing Countries — Key Challenges and Issues

Agosti, Jan M.; Goldie, Sue J.

doi:10.1056/nejmp078053

Cited by 291 publications

(205 citation statements)

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“…Cost is a major issue in developing countries as so many health priorities are competing for limited finance and resources (Agosti and Goldie, 2007). In a financial environment of austerity worldwide today and in the near future, a comprehensive cancer control program (ACCP, http://www.alliance-cxca.org/english/publications.…”

Section: Awareness Education Program-an Affordable Approach Without Ementioning

confidence: 99%

“…This approach, however, faces a dilemma in developing countries due largely to the unprecedented high price of HPV vaccines ($360 for 3 doses in the United States) (Agosti and Goldie, 2007), prohibiting widespread application in the developing world. Yet, HPV vaccines are not available at any price in China (Zhang et al, 2013) despite the country's high burden of HPV-related diseases (IARC, http://globocan.iarc.fr/fact_sheets_cancer.aspx).…”

Section: Introductionmentioning

confidence: 99%

“…This strategy may also be meaningful to high-income countries given current financial austerity worldwide. It has been estimated that, with every 5-year delay of no action (such as no HPV vaccination), more than 1.5 million more women worldwide will die from cervical cancer (Agosti and Goldie, 2007). In China alone, no action for every 5 years will cost at least 170,000 more women's lives from cervical cancer (IARC, http://globocan.iarc.fr/fact_sheets_cancer.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Implementing a Cervical Cancer Awareness Program in Low-income Settings in Western China: a Community-based Locally Affordable Intervention for Risk Reduction

Simayi¹,

Yang²,

Li³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Background: Some 60 years after introduction of the Papanicolaou smear worldwide, cervical cancer remains a burden in developing countries where >85% of world new cases and deaths occur, suggesting a failure to establish comprehensive cervical-cancer control programs. Effective interventions are available to control cervical cancer but are not all affordable in low-income settings. Disease awareness saves lives by risk-reduction as witnessed in reducing mortality of HIV/AIDS and smoking-related cancers. Subjects and Methods: We initiated a community-based awareness program on cervical cancer in two low-income Muslim Uyghur townships in Kashi (Kashgar) Prefecture, Xinjiang, China in 2008. The education involved more than 5,000 women from two rural townships and awareness was then evaluated in 2010 and 2011, respectively, using a questionnaire with 10 basic knowledge questions on cervical cancer. Demographic information was also collected and included in an EpiData database. A 10-point scoring system was used to score the awareness. Results: The effectiveness and feasibility of the program were evaluated among 4,475 women aged 19-70 years, of whom >92% lived on/ below US$1.00/day. Women without prior education showed a poor average awareness rate of 6.4% (164/2,559). A onetime education intervention, however, sharply raised the awareness rate by 4-fold to 25.5% (493/1,916). Importantly, low income and illiteracy were two reliable factors affecting awareness before or after education intervention. Conclusions: Education intervention can significantly raise the awareness of cervical cancer in low-income women. Economic development and compulsory education are two important solutions in raising general disease awareness. We propose that implementing community-based awareness programs against cervical cancer is realistic, locally affordable and sustainable in low-income countries, which may save many lives over time and, importantly, will facilitate the integration of comprehensive programs when feasible. In this context, adopting this strategy may provide one good example of how to achieve "good health at low cost".

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Section: Awareness Education Program-an Affordable Approach Without Ementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Implementing a Cervical Cancer Awareness Program in Low-income Settings in Western China: a Community-based Locally Affordable Intervention for Risk Reduction

Simayi¹,

Yang²,

Li³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…Challenges associated with the introduction of the new vaccine in these countries include the administration cost, dissemination and access to vaccines, and social cultural aspects of immunization of a sexually transmitted infection (STI) vaccine [6,7]. Numerous studies have demonstrated that public awareness of HPV, perceived risks of HPV infection, and knowledge of potential health consequences of HPV infection are low [8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Knowledge and Attitudes About HPV Infection, HPV Vaccination, and Cervical Cancer Among Rural Southeast Asian Women

Wong

2010

Int.J. Behav. Med.

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Background The incidence of cervical cancer in developing countries is high and even higher among women in rural areas in these countries. Purpose The purpose of this study is to assess the knowledge and attitudes towards human papillomavirus (HPV), HPV vaccination, and cervical cancer among young women in rural settings in a Southeast Asia country. Methods A convenience sample of ethnically diverse young rural women in Malaysia was surveyed. Participants were interviewed using a standard questionnaire. Results Among the participants (N=449), knowledge of HPV, HPV vaccination, cervical screening, and cervical cancer risk factors was extremely poor. The mean total knowledge score (14 items) was 2.37 (SD±1.97). Although many had never heard of the newly released HPV vaccine, two-thirds professed an intention to receive the HPV vaccine. Intention to receive the vaccine was significantly associated with knowledge of cervical screening and cervical cancer risk factors (OR 1.17; 95% CI 1.03-1.33; P=0.013). Reasons for vaccine refusal were doubts about safety and efficacy of the new vaccine (27.4%), perceived embarrassment at receiving an STI vaccine (20.7%), and perception of not being at risk of HPV infection (20.0%). Conclusions Providing HPV education to the rural residents is a high priority.

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“…122 Of note, Gardasil®, Gardasil 9® and Cervarix® are licensed for use in healthy women as prophylactic vaccines against multiple variants of HPV which are associated with the development of cervical carcinomas and anal cancers. 123-128 That said, these agents technically represent antiviral vaccines and have limited activity against established HPV-driven tumors. 99,129-131 …”

Section: Introductionmentioning

confidence: 99%

Trial watch: Peptide-based vaccines in anticancer therapy

et al. 2018

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Peptide-based anticancer vaccination aims at stimulating an immune response against one or multiple tumor-associated antigens (TAAs) following immunization with purified, recombinant or synthetically engineered epitopes. Despite high expectations, the peptide-based vaccines that have been explored in the clinic so far had limited therapeutic activity, largely due to cancer cell-intrinsic alterations that minimize antigenicity and/or changes in the tumor microenvironment that foster immunosuppression. Several strategies have been developed to overcome such limitations, including the use of immunostimulatory adjuvants, the co-treatment with cytotoxic anticancer therapies that enable the coordinated release of damage-associated molecular patterns, and the concomitant blockade of immune checkpoints. Personalized peptide-based vaccines are also being explored for therapeutic activity in the clinic. Here, we review recent preclinical and clinical progress in the use of peptide-based vaccines as anticancer therapeutics.Abbreviations: CMP: carbohydrate-mimetic peptide; CMV: cytomegalovirus; DC: dendritic cell; FDA: Food and Drug Administration; HPV: human papillomavirus; MDS: myelodysplastic syndrome; MHP: melanoma helper vaccine; NSCLC: non-small cell lung carcinoma; ODD: orphan drug designation; PPV: personalized peptide vaccination; SLP: synthetic long peptide; TAA: tumor-associated antigen; TNA: tumor neoantigen

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Introducing HPV Vaccine in Developing Countries — Key Challenges and Issues

Cited by 291 publications

References 8 publications

Implementing a Cervical Cancer Awareness Program in Low-income Settings in Western China: a Community-based Locally Affordable Intervention for Risk Reduction

Implementing a Cervical Cancer Awareness Program in Low-income Settings in Western China: a Community-based Locally Affordable Intervention for Risk Reduction

Knowledge and Attitudes About HPV Infection, HPV Vaccination, and Cervical Cancer Among Rural Southeast Asian Women

Trial watch: Peptide-based vaccines in anticancer therapy

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