Browse > Article
http://dx.doi.org/10.7314/APJCP.2012.13.1.305

Health and Economic Burden of HPV-related Diseases in Singapore  

Low, Jeffrey Jen Hui (Department of Obstetrics & Gynecology, National University Hospital System)
Ko, Yu (Department of Pharmacy, National University of Singapore)
Ilancheran, Arunachalam (Department of Obstetrics & Gynecology, National University Hospital System)
Zhang, Xu Hao (Medical Department, Merck Sharp & Dhome (I.A.) Corp. (Singapore Branch))
Singhal, Puneet K. (Global Outcomes Research and Reimbursement, Merck & Co., Inc.)
Tay, Sun Kuie (Department of Obstetrics & Gynaecology, Singapore General Hospital)
Publication Information
Asian Pacific Journal of Cancer Prevention / v.13, no.1, 2012 , pp. 305-308 More about this Journal
Abstract
Objective: To assess the health and economic burden of human papillomavirus (HPV)-related diseases (cervical cancer, cervical intraepithelial neoplasia (CIN) 1/2/3, and genital warts) in Singapore over a period of 25 years beginning in 2008. Methods: Incidence-based modeling was used to estimate the incidence cases and associated economic burden, with the assumption that age-stratified incidence rates will remain the same throughout the period of 25 years. The incidence rates in 2008 were projected based on data obtained from the National Cancer Registry for cervical cancer, and from a combination of published data and hospital registry review for CIN1/2/3 and genital warts. The population growth rate was factored into the projection of incidence cases over time. Direct cost data per cervical cancer and per CIN1/2/3 case were obtained from the financial database of large local hospitals while cost data for genital warts were obtained from the National Skin Center; these costs were multiplied by the number of incidence cases to produce an aggregate estimate of the economic burden over the 25-year period (in 2008 Singapore dollars) using a 3% discount rate. Results: The total number of incidence cases of HPV-disease over 25 years beginning in 2008 was estimated to be 60,183, including 8,078 for cervical cancer, 11,685 for CIN 2/3, 8,849 for CIN1, and 31,572 for genital warts. The estimated total direct cost was 83.2 million Singapore Dollars over 25 years: 57.6 million attributable to cervical cancer, 13.0 million to CIN2/3, 6.83 million to CIN1, and 5.70 million to genital warts. Conclusion: HPV-related diseases are expected to impose significant health and economic burden on the Singapore healthcare resources in the next 25 years.
Keywords
Human papillomavirus; cost of illness; Singapore;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Walboomers JM, Jacobs MV, Manos MM, et al (1999). Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189, 12-9.   DOI
2 Wiley D, Masongsong E (2006). Human papillomavirus: the burden of infection. Obstet Gynecol Surv 61, S3-14.   DOI
3 Wong WK (2008). Population Trends 2008 (Singapore Department of Statistics).
4 Insinga RP (2006). Annual productivity costs due to cervical cancer mortality in the United States. Womens Health Issues, 16, 236-42.   DOI
5 Insinga RP, Dasbach EJ, Elbasha EH (2005). Assessing the annual economic burden of preventing and treating anogenital human papillomavirus-related disease in the US: analytic framework and review of the literature. Pharmacoeconomics, 23, 1107-22.   DOI
6 Koutsky LA, Harper DM (2006). Chapter 13: Current findings from prophylactic HPV vaccine trials. Vaccine, 24, S3/114-21.
7 Ministry of Health, Singapore (2009). Communicable diseases surveillance in Singapore 2008.
8 Kulasingam SL, Hughes JP, Kiviat NB, et al (2002). Evaluation of human papillomavirus testing in primary screening for cervical abnormalities: comparison of sensitivity, specificity, and frequency of referral. JAMA, 288, 1749-57.   DOI
9 Lipsy RJ (2008). Assessing the short-term and long-term burden of illness in cervical cancer. Am J Manag Care, 14, S177-84.
10 Max W, Rice DP, Sung HY, et al (2003). The economic burden of gynecologic cancers in California, 1998. Gynecol Oncol, 88, 96-103.   DOI
11 National Health Insurance Research Database (2009). Disease Burden of Genital Wart in Taiwan.
12 National Skin Center (2006). Sexually Transmitted Infections Notification Report.
13 Paavonen J, Naud P, Salmeron J, et al (2009). Efficacy of human papillomavirus (HPV)-16/18 AS04-adjuvanted vaccine against cervical infection and precancer caused by oncogenic HPV types (PATRICIA): final analysis of a double-blind, randomised study in young women. Lancet, 374, 301-14.   DOI
14 Parkin DM, Bray F (2006). Chapter 2: The burden of HPVrelated cancers. Vaccine, S3, 11-25.
15 Singapore Cancer Registry (2004). Trends in cancer incidence in Singapore 1968-2002 (Singapore,), pp. xi, 181 , 181 map 129 cm. + 181 CD-ROM (184 183/184 in.)
16 Ebrahim SH, McKenna MT, Marks JS (2005). Sexual behaviour: related adverse health burden in the United States. Sex Transm Infect, 81, 38-40.   DOI
17 Annemans L, Remy V, Lamure E, et al (2008). Economic burden associated with the management of cervical cancer, cervical dysplasia and genital warts in Belgium. J Med Econ, 11, 135-50.   DOI
18 Chaturvedi AK (2010). Beyond cervical cancer: burden of other HPV-related cancers among men and women. J Adolesc Health, 46, S20-6.
19 Dillner J, Kjaer SK, Wheeler CM, et al (2010). Four year efficacy of prophylactic human papillomavirus quadrivalent vaccine against low grade cervical, vulvar, and vaginal intraepithelial neoplasia and anogenital warts: randomised controlled trial. BMJ, 341, c3493.   DOI