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. 2020 Apr 6;20(1):453.
doi: 10.1186/s12889-020-08545-4.

The costs of treating vaginal and vulval cancer in England (2009-2015)

Stephanie Stephens  1 , Anuja Chatterjee  2 , Victoria Coles  2 , Robin Crawford  3
Affiliations

The costs of treating vaginal and vulval cancer in England (2009-2015)

Stephanie Stephens et al. BMC Public Health. .

Abstract

Background: Human papillomavirus (HPV) infection is a pre-requisite for cervical cancer, which represents the third most common cancer among women worldwide. A causal relationship also exists between HPV and cancer in other areas of the female reproductive system including the vagina and vulva. Whilst the incidence of vaginal cancer in the UK has remained relatively stable over the past 25 years, vulval cancer rates are increasing. A body of literature exists on the epidemiology and aetiology of vaginal and vulval cancer, but little is known about the economic burden. The objective of this study was to quantify the costs of treating these cancers on the National Health Service (NHS) in England.

Methods: Inpatient and outpatient episodes were derived from Hospital Episode Statistics (HES). Health Resource Group (HRG) tariffs and National Reference Costs were used to estimate the cost of treating pre-cancerous and invasive vaginal and vulval lesions in England.

Results: The study showed that for the 5 years from 2009/2010 to 2014/2015 the total cost associated with pre-cancerous and invasive vaginal and vulval lesions was over £14 million per year on average (95% of which was attributed to inpatient costs). Vulval cancer accounted for the largest proportion; an estimated 60% of the total cost (£8.82 million). On average 4316 patients per year in England were admitted to hospital and 912 patients attended outpatient settings for pre-cancerous and invasive disease of the vagina and vulva.

Conclusion: The results indicate that vaginal and vulval cancer cost the English health care system over £14 million per year. Given the causal role of HPV in a proportion of these cancers, preventative measures such as the national HPV immunisation programme have the potential to reduce the economic burden. To ensure optimal use of NHS resources, it is important that future economic evaluations of such preventative measures consider the full burden of HPV related disease.

Keywords: Cost; England; Hospital Episode Statistics; Human papillomavirus; Resource use; Retrospective; Vaginal cancer; Vulval cancer.

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Conflict of interest statement

VC is an employee of MSD UK (previously known as Sanofi Pasteur MSD). AC and SS are employees of Pharmerit Ltd., which has received funding from MSD UK. RC has received expenses for attending international conferences from Sanofi Pasteur MSD and GSK, and has participated in an advisory board for Sanofi Pasteur MSD (all > 5 years ago).

Figures

Fig. 1
Fig. 1
Mean annual cost across genital cancer and dysplasia per type of care. *Excludes radiotherapy and chemotherapy unbundled costs a Inpatient costs b Outpatient costs c Total costs
See this image and copyright information in PMC

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