Global burden and economic impact of vaccine-preventable cancer mortality.

Abstract

10542 Background: Cancer has a high clinical and economic burden, with ~10 million deaths globally in 2020. In Europe, the total cost of cancer was €199 billion in 2018. Infections are responsible for approximately 13% of cancer cases worldwide. Human papillomavirus (HPV) and hepatitis B (HBV) are among the most important infections associated with cancer for which vaccines are available. However, global vaccination rates for these cancer-causing infections remain low (~12% for HPV; 42% for HBV). Elimination of vaccine-preventable cancers is a public health priority, and the World Health Organization (WHO) has proposed a strategy to eliminate cervical cancer and viral hepatitis by 2030. This analysis aims to estimate the global burden and economic impact due to vaccine-preventable cancer mortality. Methods: The number of deaths and Years of Life Lost (YLL) in 2019 from liver cancer caused by hepatitis B (ICD-10 C22), head and neck cancers (ICD-10 C00-14 and C32), and cancer of the cervix uteri (ICD-10 C53) were sourced from the Institute for Health Metrics Evaluation (IHME) Global Burden of Disease. Deaths and YLL were applied to attributable fractions for each vaccine-preventable cancer based on published data. The Value of YLL (VYLL) was estimated by multiplying the GDP per capita (World Bank; in USD) and YLL for each cancer, in each WHO region. Sensitivity and scenario analyses were performed to test the robustness of results. Results: In 2019, there were 479,750 potentially vaccine-preventable cancer deaths and 14,561,049 YLL (38% in males) across WHO regions (Table). The estimated economic impact due to vaccine-preventable cancer deaths was over $171 billion globally with the Americas and European region accounting for 63% of the total cost ($107 billion). Cervical cancer had the highest mortality burden (52% of total deaths). Globally, 78% of non-cervical HPV-related cancer deaths were in males. Conclusions: In 2019, 1,314 people died per day due to vaccine-preventable cancers leading to substantial YLL and economic impact. The overall burden is likely to be higher since several other HPV-related cancers were not included in this analysis. Improved implementation of HPV and HBV vaccination programs should be prioritized to decrease this burden.[Table: see text]