title: The burden and costs of prevention and management of genital disease caused by HPV in women: a population-based registry study in Finland.
abstract: The aim of this study was to evaluate the total burden and health care provider costs of prevention, management and treatment of HP-related genital disease outcomes including all organized and opportunistic screening tests. Information about HPV-related disease outcomes in the Finnish female population of 2.7 million was obtained from nationwide population-based registry data. We estimated the incidence, health care resource use, health provider costs and life years lost due to cervical, vaginal and vulvar cancer and intraepithelial neoplasia (CIN, VaIN, VIN), cervical adenocarcinoma in situ, and external genital warts. The average annual disease burden of HPV-related genital disease in the female population of Finland comprises altogether 241 cases of cervical, vaginal and vulvar cancer, 2,898 new cases of CIN, 34,432 cases of minor cytological abnormalities, and almost 4,000 cases of external genital warts. The total annual costs of screening, further diagnostics and treatment of HPV-related genital disease were € 44.7 million of which the annual costs due to cervical cancer screening were € 22.4 million and due to diagnostics, management and treatment of HPV-related genital disease outcomes were € 22.3 million. The latter included € 8.4 million due to minor cervical abnormalities detected by the current cervical screening practice. The extensive opportunistic Pap testing fails to keep the incidence of cervical cancer from increasing among women aged 30-34. In addition opportunistic screening among this and younger age group detects a significant number of cytological abnormalities, most of which are probably treated unnecessarily.
authors: Department of Vaccination and Immune Protection/Vaccination Programme Unit, National Institute for Health and Welfare (THL), FI-00271, Helsinki, Finland. heini.salo@thl.fi
authors: Heini
authors: H
authors: Salo
authors: Tuija
authors: T
authors: Leino
authors: Terhi
authors: T
authors: Kilpi
authors: Kari
authors: K
authors: Auranen
authors: Petri
authors: P
authors: Tiihonen
authors: Matti
authors: M
authors: Lehtinen
authors: Simopekka
authors: S
authors: Vänskä
authors: Miika
authors: M
authors: Linna
authors: Pekka
authors: P
authors: Nieminen
mesh_terms: D002648:Child; D005260:Female; D005387:Finland / Q000453:epidemiology; D005833:Genital Neoplasms, Female / Q000191:economics / Q000453:epidemiology / Q000517:prevention & control* / Q000628:therapy; D017048:Health Care Costs; D006295:Health Resources / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D030361:Papillomavirus Infections / Q000150:complications*; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control; D014626:Vaginal Smears / Q000191:economics; D002578:Uterine Cervical Dysplasia / Q000517:prevention & control
keywords: HPV; disease burden; economic burden