Impact of HPV vaccination: health gains in the Italian female population

Marcellusi, Andrea

doi:10.1186/s12963-017-0154-0

Population Health Metrics

Table 1 Transition probability by age

From: Impact of HPV vaccination: health gains in the Italian female population

Parameter	Description and parameters used to estimate transition probabilities	Source
Transitions from the health state (State 1)
_x λ ₁₁	Probability of permanence in healthy state without onset of HPV-related diseases (addition to 1 of the remaining probabilities from state 1) 1 − _x λ ₁₂ − _x λ ₁₃ − _x λ ₁₄ − _x λ ₁₅ − _x λ ₁₆ − _x λ ₁₈	Complementary probability
_x λ ₁₂	Probability of genital warts onset = incidence of diagnosis by age in genital warts	[11, 14, 59, 63, 64]
_x λ ₁₃	Probability to contract a CIN 1 = incidence of diagnosis by age of CIN 1	[11, 65,66,67]
_x λ ₁₄	Probability to contract a CIN 2/3 = incidence of diagnosis by age of CIN 2/3	[11, 65,66,67]
_x λ ₁₅	Probability of cervical cancer onset by age = incidence of cervical cancer by age (assuming all cancers are diagnosed)	[60]
_x λ ₁₆	Probability of anal cancer onset by age = incidence of anal cancer by age (assuming all cancers are diagnosed)	[60, 68]
Transitions from the genital warts state (State 2)
_x λ ₂₂	Probability of permanence of genital warts by age = Recurrence rate of genital warts by age between age x − 1 and x	[11, 59, 69]
_x λ ₂₁	Probability of healing from genital warts = 1 − _x λ ₂₂ − _x λ ₂₈	Complementary probability
Transitions from state of CIN 1 (State 3)
_x λ ₃₃	Probability of permanence of CIN 1 by age =1 − _x λ ₃₁ − _x λ ₃₈	Complementary probability
_x λ ₃₄	Transition probability from CIN 1 to CIN 2/3 = progression rate of the disease by age from state CIN 1 to CIN 2/3	[11, 70]
_x λ ₃₁	Probability of healing from CIN 1 by age = spontaneous regression rate of the disease by age. In this case women are only observed and not treated.	[11, 70,71,72]
Transitions from state of CIN 2/3 (State 4)
_x λ ₄₄	Probability of permanence in CIN 2/3 =1 − _x λ ₄₁ − _x λ ₄₈	Complementary probability
_x λ ₄₁	Probability of healing from CIN 2/3 by age = efficacy rate of health care intervention on diagnosed women (Constant by age)	[11, 70,71,72]
_x λ ₄₅	Transition probability from CIN 2/3 to CCU state by age for lack of efficacy of health care intervention = progression rate of the disease by age	[11, 66, 70,71,72]
Transitions from Cervical cancer state (State 5)
_x λ ₅₅	Probability of permanence of CCU state by age = recurrence rate (recurrence of disease) of CCU	[73, 74]
_x λ ₅₁	Probability of healing from cervical cancer state by age = 1 − _x λ ₅₅ − _x λ ₅₇−_x λ ₅₉	Complementary probability
_x λ ₅₇	Probability of death from cervical cancer by age for ill subjects =1 − _x λ ₅₉ − 5 − year survival by age	[28, 75]
Transitions from Anal Cancer (State 6)
_x λ ₆₆	Probability of permanence in CCU state by age = recurrence rate of anal cancer (recurrence of disease)	[68]
_x λ ₆₁	Probability of healing from cervical cancer state by age =1 − _x λ ₆₆ − _x λ ₆₇−_x λ ₆₉	[28, 75]
_x λ ₆₈	Probability of death from anal cancer by age for ill subjects =1 − _x λ ₆₉ − 5 − year survival by age	Complementary probability
Transitions to death for other causes (State i - > State 9)
_x λ _i9 i = 1, 2, 3, 4, 5,6	Probability of death by age from any state for other causes except for cervical cancer = Probability of general death by age	[28]

Legend: i = state of origin; j = state of destination; x = Age group: 0–4, 5–9, 10–14, 15–19, 20–24, 25–29, 30–34, 35–39, 40–44, 45–49, 50–54, 55–59, 60–64, 65–69, 70–74, 75–79, 80–84, ≥85;

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ISSN: 1478-7954

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