Global burden and economic impact of vaccine-preventable cancer mortality.

person Goran Bencina Center for Observational and Real-World Evidence, MSD Spain, Madrid, Spain info_outline Goran Bencina, Edward Oliver, Anne Meiwald, Robert Hughes, Edith Morais, Julia A Schillinger, Georgie Weston

Authors person Goran Bencina Center for Observational and Real-World Evidence, MSD Spain, Madrid, Spain info_outline Goran Bencina, Edward Oliver, Anne Meiwald, Robert Hughes, Edith Morais, Julia A Schillinger, Georgie Weston Organizations Center for Observational and Real-World Evidence, MSD Spain, Madrid, Spain, Adelphi Values, Bollington, United Kingdom, Merck Sharp & Dohme, Lyon, France, Merck & Co., Inc., Rahway, NJ Abstract Disclosures Research Funding Pharmaceutical/Biotech Company Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA. Background: Cancer has a high clinical and economic burden, with ~10 million deaths globally in 2020. In Europe, the total cost of cancer was €199 billion in 2018. Infections are responsible for approximately 13% of cancer cases worldwide. Human papillomavirus (HPV) and hepatitis B (HBV) are among the most important infections associated with cancer for which vaccines are available. However, global vaccination rates for these cancer-causing infections remain low (~12% for HPV; 42% for HBV). Elimination of vaccine-preventable cancers is a public health priority, and the World Health Organization (WHO) has proposed a strategy to eliminate cervical cancer and viral hepatitis by 2030. This analysis aims to estimate the global burden and economic impact due to vaccine-preventable cancer mortality. Methods: The number of deaths and Years of Life Lost (YLL) in 2019 from liver cancer caused by hepatitis B (ICD-10 C22), head and neck cancers (ICD-10 C00-14 and C32), and cancer of the cervix uteri (ICD-10 C53) were sourced from the Institute for Health Metrics Evaluation (IHME) Global Burden of Disease. Deaths and YLL were applied to attributable fractions for each vaccine-preventable cancer based on published data. The Value of YLL (VYLL) was estimated by multiplying the GDP per capita (World Bank; in USD) and YLL for each cancer, in each WHO region. Sensitivity and scenario analyses were performed to test the robustness of results. Results: In 2019, there were 479,750 potentially vaccine-preventable cancer deaths and 14,561,049 YLL (38% in males) across WHO regions (Table). The estimated economic impact due to vaccine-preventable cancer deaths was over $171 billion globally with the Americas and European region accounting for 63% of the total cost ($107 billion). Cervical cancer had the highest mortality burden (52% of total deaths). Globally, 78% of non-cervical HPV-related cancer deaths were in males. Conclusions: In 2019, 1,314 people died per day due to vaccine-preventable cancers leading to substantial YLL and economic impact. The overall burden is likely to be higher since several other HPV-related cancers were not included in this analysis. Improved implementation of HPV and HBV vaccination programs should be prioritized to decrease this burden. Deaths, YLL and VYLL due to vaccine-preventable cancers. Region Deaths (total) Deaths (% Male/% Female) YLL (total) YLL (% Male/% Female) VYLL ($) African 56,777 11/89 1,948,911 11/89 6,781,797,190 Eastern Mediterranean 16,466 36/64 548,777 34/66 8,977,158,196 European 51,816 34/66 1,377,083 34/66 53,957,605,778 The Americas 51,150 14/86 1,492,493 13/87 53,659,526,030 South-East Asia 101,136 30/70 3,197,870 29/71 36,719,638,991 Western Pacific 202,406 58/42 5,995,916 60/40 11,768,800,297 Global* 479,750 39/61 14,561,049 38/62 171,864,526,482 *Sum of all WHO regions.