Economic burden of human papilloma virus related diseases in China: a systematic review and synthetic analysis

Objective To integrate cost-related data of human papilloma virus (HPV) related diseases from Mainland China and estimate the economic burden. Methods We uesd "Cost/expense" combined with names of the nine major HPV-related diseases, i.e. cervical cancer, vaginal cancer, vulva cancer, anal cancer, penile cancer, oropharyngeal cancer, cervical intraepithelial neoplasia (CIN), ano- genital warts (AGW), and recurrent respiratory papillomatosis (RRP), as keywords. Seven databases in- cluding PubMed and China National Knowledge Infrastructure were selected, for literature targeting pa-tients in mainland China published between 2001-2020. Various cost-related data were extracted, and cost data were adjusted annually to 2020 according to appropriate consumer price indices. Data were used to estimate per-capita direct medical costs, direct non-medical costs, and indirect costs for each of the nine diseases. The incidence, prevalence, and HPV attribution fraction of each of the nine diseases were collected to further estimate the total economic burden of HPV-related diseases in Mainland China in 2020. Results A total of 247 articles were included. Annual per-capita total costs of each of the six cancers ranged from 58 189 to 79 567 yuan in the first year of the disease and from 13 025 to 27 965 yuan in each subsequent year. Annual per-capita total costs of RRP were 41 329 yuan. Per-capita total costs of CIN and AGW ranged between 6 452 and 13 602 yuan. The total economic burden due to HPV-related diseases in Mainland China in 2020 was about 18. 03 billion yuan, with cervical cancer accounting for 9.69 billion yuan. Direct medical costs were a significant part of the economic burden, accounting for 70% of the total burden, with 7.0 billion yuan in direct medical costs due to cervical cancer. Conclu- sions The annual economic burden of HPV-related diseases in Mainland China cannot be ignored. Scal- ing up HPV vaccination is needed to reduce associated economic losses.