Conflict of interest: Heini Salo, Tuija Leino, Terhi Kilpi, Pekka Nieminen, were members of the National Expert Group on HPV Related Disease Prevention. Terhi Kilpi is principal investigator of a nationwide effectiveness study of the ten-valent pneumococcal conjugate vaccine mainly funded by GlaxoSmithKline. Matti Lehtinen has received grants for HPV vaccination studies through his employer University of Tampere, Finland from Merck&Co. Inc and GSK Biologicals. Pekka Nieminen has been a medical consultant for GlaxoSmithKline Ltd. and Sanofi-Pasteur MSD Ltd.
The burden and costs of prevention and management of genital disease caused by HPV in women: A population-based registry study in Finland
Article first published online: 5 APR 2013
Copyright © 2013 UICC
International Journal of Cancer
Volume 133, Issue 6, pages 1459–1469, 15 September 2013
How to Cite
Salo, H., Leino, T., Kilpi, T., Auranen, K., Tiihonen, P., Lehtinen, M., Vänskä, S., Linna, M. and Nieminen, P. (2013), The burden and costs of prevention and management of genital disease caused by HPV in women: A population-based registry study in Finland. Int. J. Cancer, 133: 1459–1469. doi: 10.1002/ijc.28145
- Issue published online: 8 JUL 2013
- Article first published online: 5 APR 2013
- Accepted manuscript online: 5 MAR 2013 10:35PM EST
- Manuscript Accepted: 18 FEB 2013
- Manuscript Received: 23 AUG 2012
- disease burden;
- economic burden
The aim of this study was to evaluate the total burden and health care provider costs of prevention, management and treatment of HP-related genital disease outcomes including all organized and opportunistic screening tests. Information about HPV-related disease outcomes in the Finnish female population of 2.7 million was obtained from nationwide population-based registry data. We estimated the incidence, health care resource use, health provider costs and life years lost due to cervical, vaginal and vulvar cancer and intraepithelial neoplasia (CIN, VaIN, VIN), cervical adenocarcinoma in situ, and external genital warts. The average annual disease burden of HPV-related genital disease in the female population of Finland comprises altogether 241 cases of cervical, vaginal and vulvar cancer, 2,898 new cases of CIN, 34,432 cases of minor cytological abnormalities, and almost 4,000 cases of external genital warts. The total annual costs of screening, further diagnostics and treatment of HPV-related genital disease were €44.7 million of which the annual costs due to cervical cancer screening were €22.4 million and due to diagnostics, management and treatment of HPV-related genital disease outcomes were €22.3 million. The latter included €8.4 million due to minor cervical abnormalities detected by the current cervical screening practice. The extensive opportunistic Pap testing fails to keep the incidence of cervical cancer from increasing among women aged 30–34. In addition opportunistic screening among this and younger age group detects a significant number of cytological abnormalities, most of which are probably treated unnecessarily.