背景:世界卫生组织旨在全球消除宫颈癌,需要进行建模研究以预测长期结果。
目的:本文介绍了一个宏观模拟框架,使用年龄-时期-队列模型和人群归因分数来预测台湾消除宫颈癌的时间表。
方法:1997年至2016年的宫颈癌病例数据来自台湾癌症登记处。当前方法和各种干预策略下的未来发病率,例如扩大筛查(基于细胞学或基于人乳头瘤病毒[HPV])和HPV疫苗接种,被预测。
结果:我们的预测表明,到2050年,台湾可以在基于细胞学或基于HPV的筛查中达到70%的依从性或90%的HPV疫苗接种覆盖率的情况下消除宫颈癌。预计消除的年份是2047年和2035年,用于基于细胞学和基于HPV的筛查,分别;2050年用于单独疫苗接种;2038年和2033年用于联合筛查和疫苗接种方法。
结论:年龄期队列宏观模拟框架为宫颈癌控制提供了有价值的政策分析工具。我们的发现可以为其他高发国家的策略提供信息,作为全球努力消除这种疾病的基准。
BACKGROUND: The World Health Organization aims for the global elimination of cervical cancer, necessitating modeling studies to forecast long-term outcomes.
OBJECTIVE: This paper introduces a
macrosimulation framework using age-period-cohort modeling and population attributable fractions to predict the timeline for eliminating cervical cancer in Taiwan.
METHODS: Data for cervical cancer cases from 1997 to 2016 were obtained from the Taiwan Cancer Registry. Future incidence rates under the current approach and various intervention strategies, such as scaled-up screening (cytology based or human papillomavirus [HPV] based) and HPV vaccination, were projected.
RESULTS: Our projections indicate that Taiwan could eliminate cervical cancer by 2050 with either 70% compliance in cytology-based or HPV-based screening or 90% HPV vaccination coverage. The years projected for elimination are 2047 and 2035 for cytology-based and HPV-based screening, respectively; 2050 for vaccination alone; and 2038 and 2033 for combined screening and vaccination approaches.
CONCLUSIONS: The age-period-cohort
macrosimulation framework offers a valuable policy analysis tool for cervical cancer control. Our findings can inform strategies in other high-incidence countries, serving as a benchmark for global efforts to eliminate the disease.