Abstract
ObjectiveCosts associated with HPV-related diseases such as cervical dysplasia, cervical cancer, and genital warts have not been evaluated in Sweden. These costs must be estimated in order to determine the potential savings if these diseases were eradicated and to assess the combined cost-effectiveness of HPV vaccination and cervical cancer screening. The present study aimed to estimate prevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts from a societal perspective in Sweden in 2009, 1 year before the quadrivalent HPV vaccination program was implemented.Methods and MaterialsData from the Swedish cervical cancer screening program was used to calculate the costs associated with prevention (cytological cervical cancer screening), management (colposcopy and biopsy following inadequate/abnormal cytological results), and treatment of CIN. Swedish official statistics were used to estimate treatment costs associated with cervical cancer. Published epidemiological data were used to estimate the number of incident, recurrent, and persistent cases of genital warts; a clinical expert panel assessed management and treatment procedures. Estimated visits, procedures, and use of medications were used to calculate the annual cost associated with genital warts.ResultsFrom a societal perspective, total estimated costs associated with cervical cancer and genital warts in 2009 were €106.6 million, of which €81.4 million (76%) were direct medical costs. Costs associated with prevention, management, and treatment of CIN were €74 million; screening and management costs for women with normal and inadequate cytology alone accounted for 76% of this sum. The treatment costs associated with incident and prevalent cervical cancer and palliative care were €23 million. Estimated costs for incident, recurrent and persistent cases of genital warts were €9.8 million.ConclusionPrevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts are substantial. Defining these costs is important for future cost-effectiveness analyses of the quadrivalent HPV vaccination program in Sweden.
Highlights
Each year 34 300 women in Europe are diagnosed with cervical cancer, and 16 300 die from this disease [1]
Costs associated with Human papillomavirus (HPV)-related diseases such as cervical dysplasia, cervical cancer, and genital warts have not been evaluated in Sweden
The present study aimed to estimate prevention, management, and treatment costs associated with cervical dysplasia, cervical cancer, and genital warts from a societal perspective in Sweden in 2009, 1 year before the quadrivalent HPV vaccination program was implemented
Summary
Each year 34 300 women in Europe are diagnosed with cervical cancer, and 16 300 die from this disease [1]. Human papillomavirus (HPV) infection is a necessary cause of cervical cancer and genital warts [4,5]. The non-oncogenic HPV types 6 and 11 cause low-grade cervical lesions and about 90% of all cases of genital warts [8,9,10]. In contrast to other malignancies, cervical cancer is more prevalent among younger women, with incidence rising rapidly after the age of 25–30 years. This incidence could be prevented by adequate screening, and primary prevention with HPV vaccination [11]
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