Health and Economic Burden of HPV-related Diseases in Singapore


Objective: To assess the health and economic burden of human papillomavirus (HPV)-related diseases(cervical cancer, cervical intraepithelial neoplasia (CIN) 1/2/3, and genital warts) in Singapore over a periodof 25 years beginning in 2008.
Methods: Incidence-based modeling was used to estimate the incidence casesand associated economic burden, with the assumption that age-stratified incidence rates will remain the samethroughout the period of 25 years. The incidence rates in 2008 were projected based on data obtained from theNational Cancer Registry for cervical cancer, and from a combination of published data and hospital registryreview for CIN1/2/3 and genital warts. The population growth rate was factored into the projection of incidencecases over time. Direct cost data per cervical cancer and per CIN1/2/3 case were obtained from the financialdatabase of large local hospitals while cost data for genital warts were obtained from the National Skin Center;these costs were multiplied by the number of incidence cases to produce an aggregate estimate of the economicburden over the 25-year period (in 2008 Singapore dollars) using a 3% discount rate.
Results: The total numberof incidence cases of HPV-disease over 25 years beginning in 2008 was estimated to be 60,183, including 8,078for cervical cancer, 11,685 for CIN 2/3, 8,849 for CIN1, and 31,572 for genital warts. The estimated total directcost was 83.2 million Singapore Dollars over 25 years: 57.6 million attributable to cervical cancer, 13.0 million toCIN2/3, 6.83 million to CIN1, and 5.70 million to genital warts.
Conclusion: HPV-related diseases are expectedto impose significant health and economic burden on the Singapore healthcare resources in the next 25 years.