Modelling cervical cancer due to human papillomavirus infection in the presence of vaccination

Cervical cancer is a global threat with over half a million cases worldwide and over 200000 deaths annually. Sexual minority women are at risk for infection with human papillomavirus (HPV); the virus which causes cervical cancer, yet little is known about the prevalence of HPV infection. In this paper, the dynamics of HPV infection in the presence of vaccination among women which progresses to cervical cancer is investigated. The disease-free equilibrium state of the model is determined. Using the next generation method, the cancer reproduction number, R 0 , is computed in terms of the model parameters and used as a threshold value. The reproduction number is examined analytically for its sensitivity to the vaccination parameter having shown that it is locally and globally asymptotically stable for R 0 < 1 and unstable for R 0 > 1 at the disease free state. The centre manifold theorem is used to determine the stability of the endemic equilibrium and shown to exhibit a backward bifurcation phenomenon implying that cervical cancer due to HPV infection may persist in the population even if R 0 < 1 . Finally, numerical simulations are carried out to obtain analytical results. As prevalence estimates vary between sexual orientation dimensions, these findings help inform targeted HPV and cervical cancer prevention efforts.