• Nicole G Campos, Monisha Sharma, Andrew Clark, Kyueun Lee, Fangli Geng, Catherine Regan, Jane Kim, and Stephen Resch.
• Department of Health Policy and Management, Center for Health Decision Science, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
• Int J Gynaecol Obstet. 2017 Jul 1; 138 Suppl 1: 47-56.

ObjectiveTo estimate the health impact, financial costs, and cost-effectiveness of scaling-up coverage of human papillomavirus (HPV) vaccination (young girls) and cervical cancer screening (women of screening age) for women in countries that will likely need donor assistance.MethodsWe used a model-based approach to synthesize population, demographic, and epidemiological data from 50 low- and lower-middle-income countries. Models were used to project the costs (US $), lifetime health impact (cervical cancer cases, deaths averted), and cost-effectiveness (US $ per disability adjusted life year [DALY] averted) of: (1) two-dose HPV-16/18 vaccination of girls aged 10 years; (2) once-in-a-lifetime screening, with treatment when needed, of women aged 35 years with either HPV DNA testing or visual inspection with acetic acid (VIA); and (3) cervical cancer treatment over a 10-year roll-out.ResultsWe estimated that both HPV vaccination and screening would be very cost-effective, and a comprehensive program could avert 5.2 million cases, 3.7 million deaths, and 22.0 million DALYs over the lifetimes of the intervention cohorts for a total 10-year program cost of US $3.2 billion.ConclusionInvestment in HPV vaccination of young girls and cervical cancer screen-and-treat programs in low- and lower-middle-income countries could avert a substantial burden of disease while providing good value for public health dollars.© 2017 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

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