The indirect costs and burden of vaccine-preventable cancers premature mortality in Asia-Pacific countries

Abstract

Background: Cancer is the second leading cause of death in the Asia-Pacific region. Human papillomavirus (HPV) and hepatitis B virus (HBV) are major cancer-causing infections. This analysis assessed the mortality impact and productivity losses due to HBV- and HPV-related cancers in ten Asia-Pacific countries.

Methods: Number of deaths and years of life lost (YLL) in 2019 were sourced from the Institute for Health Metrics Evaluation Global Burden of Disease for the following: HBV-related liver cancer, and HPV-related oral cavity, larynx, oropharynx, and cervical cancers (other HPV-related cancers were not included). Ten countries from the Asia-Pacific region were included. Attributable fractions of HPV-related cancers were applied. Average YLL (AYLL) was calculated as the average number of years a person would have lived if they had not died prematurely. The value of YLL (VYLL) was estimated using GDP per capita and YLL. Discount rate of 3% was applied to adjust future health losses to present value. Sensitivity and scenario analyses were also conducted to assess the robustness of the results.

Results: In 2019, 52,796 deaths and 1,493,438 YLL were caused by HBV- and HPV-related cancer in the selected Asia-Pacific countries, incurring a productivity loss of $15 billion. Liver cancer accounted for 62.2% of the total productivity loss followed by cervical cancer (35.5%). The Asia-Pacific region had an AYLL of 28, with values ranging from 21 (Japan) to 34 (Philippines). Republic of Korea had the highest productivity losses followed by Japan and Thailand ($5.6, $4.3 and $1.8 billion, respectively).

Conclusion: The Asia-Pacific region bears a significant economic burden from potentially vaccine-preventable cancers. Enhanced public health measures, including screening and expanded HBV and HPV vaccination coverage, could alleviate this burden.

Keywords: Health economics; I10; hepatitis B virus; human papillomavirus; i18; indirect costs; prevention and control; vaccine.