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. 2020 Jan 26;8(1):47.
doi: 10.3390/vaccines8010047.

Evaluation of the Burden of HPV-Related Hospitalizations as a Useful Tool to Increase Awareness: 2007-2017 Data from the Sicilian Hospital Discharge Records

Vincenzo Restivo  1 , Claudio Costantino  1 , Livia Amato  1 , Stefania Candiloro  1 , Alessandra Casuccio  1 , Marianna Maranto  1 , Alessandro Marrella  1 , Sara Palmeri  1 , Stefano Pizzo  1 , Francesco Vitale  1 , Emanuele Amodio  1
Affiliations

Evaluation of the Burden of HPV-Related Hospitalizations as a Useful Tool to Increase Awareness: 2007-2017 Data from the Sicilian Hospital Discharge Records

Vincenzo Restivo et al. Vaccines (Basel). .

Abstract

In light of the implementation of human papillomavirus (HPV) prevention strategies, epidemiological studies in different geographical areas are required in order to assess the impact of HPV-related diseases. The purpose of the present study was to describe the burden of HPV-related hospitalizations in Sicily. A retrospective observational study estimated 43,531 hospitalizations attributable to HPV from 2007 to 2017. During the observed period, there was a decrease for all HPV-related conditions with a higher reduction, among neoplasms, for cervical cancer (annual percent change (APC) = -9.9%, p < 0.001). The median age for cervical cancer was 45 years old, with an increasing value from 43 to 47 years (p < 0.001). The age classes with greater decreases in hospital admissions for invasive cancers were women aged 35 years or more (APC range from -5.5 to -9.86) and 25-34 years old (APC = -11.87, p < 0.001) for women with cervical carcinoma in situ. After ten years for vaccine introduction and sixteen years for cervical cancer screening availability, a relatively large decrease in hospital admissions for cervical cancer and other HPV-related diseases in Sicily was observed. Some clinical characteristics of hospitalization, such as increasing age, are suggestive clues for the impact of preventive strategies, but further research is needed to confirm this relationship.

Keywords: HPV vaccine; HPV-related disease; Italy; burden; cervical cancer; cervical cancer screening; hospitalization rate; impact evaluation; screening effectiveness; vaccine effectiveness.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Trends and average annual percentage change (APC) observed for HPV-related hospitalization rates from 2007 to 2017. (a) Cervical cancer; (b) Oropharynx cancer; (c) Anus cancer; (d) Penis cancer; (e) Vulva and vagina cancer; (f) Genital warts. * Indicates that the APC is significantly different from zero at the alpha = 0.05 level.
Figure 1
Figure 1
Trends and average annual percentage change (APC) observed for HPV-related hospitalization rates from 2007 to 2017. (a) Cervical cancer; (b) Oropharynx cancer; (c) Anus cancer; (d) Penis cancer; (e) Vulva and vagina cancer; (f) Genital warts. * Indicates that the APC is significantly different from zero at the alpha = 0.05 level.
Figure 2
Figure 2
Age distribution of hospital admission rates for invasive cervical cancer from 2007 to 2017.
Figure 3
Figure 3
Age distribution of hospital admission rates for cervical carcinoma in situ from 2007 to 2017.
See this image and copyright information in PMC

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