title: Health and economic burden of HPV-related diseases in Singapore.
abstract: 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 period of 25 years beginning in 2008.
  
  
  METHODS
  Incidence-based modeling was used to estimate the incidence cases and associated economic burden, with the assumption that age-stratified incidence rates will remain the same throughout the period of 25 years. The incidence rates in 2008 were projected based on data obtained from the National Cancer Registry for cervical cancer, and from a combination of published data and hospital registry review for CIN1/2/3 and genital warts. The population growth rate was factored into the projection of incidence cases over time. Direct cost data per cervical cancer and per CIN1/2/3 case were obtained from the financial database 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 economic burden over the 25-year period (in 2008 Singapore dollars) using a 3% discount rate.
  
  
  RESULTS
  The total number of incidence cases of HPV-disease over 25 years beginning in 2008 was estimated to be 60,183, including 8,078 for cervical cancer, 11,685 for CIN 2/3, 8,849 for CIN1, and 31,572 for genital warts. The estimated total direct cost was 83.2 million Singapore Dollars over 25 years: 57.6 million attributable to cervical cancer, 13.0 million to CIN2/3, 6.83 million to CIN1, and 5.70 million to genital warts.
  
  
  CONCLUSIONS
  HPV-related diseases are expected to impose significant health and economic burden on the Singapore healthcare resources in the next 25 years.
authors.affiliation: Department of Obstetrics and Gynecology, National University Hospital System, Singapore.
authors.forename: Jeffrey Jen Hui
authors.initials: JJ
authors.lastname: Low
authors.forename: Yu
authors.initials: Y
authors.lastname: Ko
authors.forename: Arunachalam
authors.initials: A
authors.lastname: Ilancheran
authors.forename: Xu Hao
authors.initials: XH
authors.lastname: Zhang
authors.forename: Puneet K
authors.initials: PK
authors.lastname: Singhal
authors.forename: Sun Kuie
authors.initials: SK
authors.lastname: Tay
mesh_terms: D000293:Adolescent; D000328:Adult; D002294:Carcinoma, Squamous Cell / Q000191:economics* / Q000453:epidemiology / Q000821:virology; D002648:Child; D002675:Child, Preschool; D003218:Condylomata Acuminata / Q000191:economics* / Q000453:epidemiology / Q000821:virology; D003362:Cost-Benefit Analysis; D003695:Delivery of Health Care / Q000191:economics*; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D008875:Middle Aged; D027383:Papillomaviridae / Q000302:isolation & purification; D030361:Papillomavirus Infections / Q000191:economics* / Q000453:epidemiology / Q000821:virology; D011379:Prognosis; D012846:Singapore / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000191:economics* / Q000453:epidemiology / Q000821:virology; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000191:economics* / Q000453:epidemiology / Q000821:virology