Abstract
BackgroundBesides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV) contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. HPV types 16 & 18 in particular contribute to 74-93% of these cases. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The aim of this study was to estimate the incidence and the health care sector costs of anal, penile, vaginal and vulvar cancer.MethodsNew anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes. Resource use in the health care sector was estimated for the year prior to diagnosis, and for the first, second and third years after diagnosis. Hospital resource use was defined in terms of registered hospital contacts, using DRG (Diagnosis Related Groups) and DAGS (Danish Outpatient Groups System) charges as cost estimates for inpatient and outpatient contacts, respectively. Health care consumption by cancer patients diagnosed in 2004–2007 was compared with that by an age- and sex-matched cohort without cancer. Hospital costs attributable to four anogenital cancers were estimated using regression analysis.ResultsThe annual incidence of anal cancer in Denmark is 1.9 per 100,000 persons. The corresponding incidence rates for penile, vaginal and vulvar cancer are 1.7, 0.9 and 3.6 per 100,000 males/females, respectively. The total number of new cases of these four cancers in Denmark is about 270 per year. In comparison, the total number of new cases cervical cancer is around 390 per year. The total cost of anogenital cancer to the hospital sector was estimated to be 7.6 million Euros per year. Costs associated with anal and vulvar cancer constituted the majority of the costs.ConclusionsAnogenital cancer incurs considerable costs to the Danish hospital sector. It is expected that the current HPV vaccination program will markedly reduce this burden.
Highlights
Besides being a causative agent for genital warts and cervical cancer, human papillomavirus (HPV)contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions
New anogenital cancer patients were identified from the Danish National Cancer Register using ICD-10 diagnosis codes
Costs associated with anal and vulvar cancer constituted the majority of the costs
Summary
Contributes to 40-85% of cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. Overall the number of new cases of these four cancers may be relatively high implying notable health care cost to society. The introduction of two vaccines against human papillomavirus (HPV) types 16 & 18 and types 6, 11, 16 & 18, respectively, was primarily intended to protect against cervical cancer (and precancerous lesions) and genital warts. HPV contributes to 40-85% of all cases of anal, penile, vaginal and vulvar cancer and precancerous lesions. Less information is available on other HPV-related cancers but the total number of new cases of anal, penile, vaginal and vulvar cancer may be relatively high, implying considerable health care costs to society [11]. The incidence of cervical cancer has remained stable over the last decade [11,13], the incidence of anal and vulvar cancer has increased [11]
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