The Indirect Costs and Burden of Vaccine Preventable Cancers Mortality in Middle East and North Africa (MENA) Countries

OBJECTIVES: Infections are responsible for ~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. The objective of this study was to estimate the mortality impact and indirect cost of cancers potentially preventable by vaccination in selected MENA (Middle East and North Africa) countries.

METHODS: The number of deaths and years of life lost (YLL) in 2019 from liver cancer caused by HBV (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 Global Burden of Disease. Deaths and YLL were applied to HPV and HBV attributable fractions based on published data. The value of YLL (VYLL) was estimated by multiplying GDP per capita (World Bank; in USD) and YLL. All MENA countries were included, except Yemen and Kuwait due to data limitations.

RESULTS: In 2019, the lost value in productivity due to vaccine-preventable cancers was $1.71 billion in the selected countries, due to 11,684 preventable deaths. On average, 32 years of life were lost per death, however UAE had an average YLL of 38 years indicating deaths occurred at a younger age and Israel. Turkey had a YLL of 25, indicating deaths occurred at an older age. The highest indirect costs were in Turkey (VYLL of $382M), Saudi Arabia (VYLL of $238M) and UAE (VYLL of $186M). The range of indirect cost/death was $14,949 – 1,378,524 (Sudan versus Qatar), with an average of $146,209/death, demonstrating variations in both YLL and GDP.

CONCLUSIONS: There is high burden and economic impact of potentially vaccine preventable cancers in MENA region. Improved implementation and increase of vaccine coverage of HPV and HBV vaccination programs should be prioritized to decrease this burden.