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Human papillomavirus, or HPV, is a sexually transmittable virus infection,which is necessary risk factor for developing cervical cancer, first mostcommon type of cancer in working age women in Moldova. We observe bothbehavioral change (sexuality increase) and demographical change (populationageing). We used data since 1998 (Moldovan peace treaty) to adjust modelparameter and we project till around 2030 (for vaccination till 2050).According to provided information, interdisciplinary model was proposed. It issset of deterministic differential equations. Stochasticity was introduced insexual partner change rates. The model has aggregated the most important pathsof infection, cancer development and prevention scenarios (more than 100equations and 200 parameters). Moldovan cervical cancer perspective looks muchbetter, than in central western Europe countries, because of relatively youngsociety. In our setup, obligatory vaccination seems to not be so crucial (fornone of realistic scenarios increase of cancer cases is possible) for publichealth, as in most countries in European Union. However, screening practicecould be verified in terms of efficiency, when cost benefit calculation wouldbe done. We propose more optimal screening guidelines (with prevention cost 5-10k EUR per QALY), which could provide saving perspective in 10-15 year inrange 150-300k EUR yearly. Targeted vaccination could be also consider, becausecosts are similar to high frequencies screening schema with the same cancercases projection. However, some positive side effects of vaccination asreduction of pathogen circulation in society, will cause decrease of otherpathologies related to HPV like genital warts and other cancer.

HPV and cervical cancer in Moldova, epidemiological model with intervention cost vs benefit and effectiveness analysis