AGE OF DISEASE CAUSAL HUMAN PAPILLOMA VIRUS (HPV) INFECTION FOR OROPHARYNGEAL CANCER IN FINLAND AND POLAND: A MODELING STUDY
Author(s)
Alhaji Cherif, DPhil1, Abhijoy Kumar, MSc2, Sreetama Sarkar, MSc2, Gargi Baluni, MSc2, Aastha Bharti, MSc2, Stina Salomonsson, PhD3, Stefano Valente, MD4, Ugne Sabale, MSc5.
1Merck & Co, West Point, PA, USA, 2Peritia, Morrisville, NC, USA, 3MSD, Stockholm, Sweden, 4MSD, Rome, Italy, 5Value & Implementation Outcomes Research, MSD, Vilnius, Lithuania.
1Merck & Co, West Point, PA, USA, 2Peritia, Morrisville, NC, USA, 3MSD, Stockholm, Sweden, 4MSD, Rome, Italy, 5Value & Implementation Outcomes Research, MSD, Vilnius, Lithuania.
OBJECTIVES: Approximately 50-60% of oropharyngeal cancers (OPC) are attributable to high-risk oral HPV infection, with the highest burden among males. Although oncogenic HPV acquisition is commonly assumed to occur shortly after sexual debut and decline with age, evidence suggests that infections linked to OPC may arise beyond early adulthood. This study estimates the age at acquisition of causal HPV infection leading to HPV‑attributable OPC among males in Finland and Poland.
METHODS: An individual-level microsimulation model of oral HPV transmission and OPC disease progression among heterosexual men (15-100 years) was adapted and parameterized using country-specific demographic, sexual behavior, and epidemiological data. The model simulated 100,000 men transitioning through four health states: susceptible, infection, OPC diagnosis, and death. Infection risk was determined by partner-level exposure, including number and age distribution of oral sex partners, oral HPV prevalence, and transmission probabilities. Age-specific oral HPV prevalence and OPC incidence were used for model calibration across >100 parameter sets. Age distribution of disease-causal infections was derived using goodness-of-fit statistics.
RESULTS: The estimated median age at acquisition of disease-causal oral HPV infection was 22.8 (SD 0.7) years in Finland and 25.1 (SD 0.6) years in Poland. A substantial proportion of causal infections was predicted to occur beyond early adulthood: 37.2% (SD 3.0) and 46.9% (SD 2.3) were acquired after age 26, while 7.9% (SD 1.6) and 11.3% (SD 1.6) were acquired after age 45, in Finland and Poland, respectively. The estimated latency period between causal infection and OPC diagnoses was 40.2 (SD 1.2) years in Finland and 34.7 (SD 1.1) years in Poland.
CONCLUSIONS: A considerable proportion of causal HPV infections leading to OPC in men are acquired after age 26, indicating sustained HPV transmission and oncogenic risk beyond early adulthood. Long latency underscores the importance of considering mid-life HPV acquisition in prevention strategies, including catch-up vaccination targeting older males.
METHODS: An individual-level microsimulation model of oral HPV transmission and OPC disease progression among heterosexual men (15-100 years) was adapted and parameterized using country-specific demographic, sexual behavior, and epidemiological data. The model simulated 100,000 men transitioning through four health states: susceptible, infection, OPC diagnosis, and death. Infection risk was determined by partner-level exposure, including number and age distribution of oral sex partners, oral HPV prevalence, and transmission probabilities. Age-specific oral HPV prevalence and OPC incidence were used for model calibration across >100 parameter sets. Age distribution of disease-causal infections was derived using goodness-of-fit statistics.
RESULTS: The estimated median age at acquisition of disease-causal oral HPV infection was 22.8 (SD 0.7) years in Finland and 25.1 (SD 0.6) years in Poland. A substantial proportion of causal infections was predicted to occur beyond early adulthood: 37.2% (SD 3.0) and 46.9% (SD 2.3) were acquired after age 26, while 7.9% (SD 1.6) and 11.3% (SD 1.6) were acquired after age 45, in Finland and Poland, respectively. The estimated latency period between causal infection and OPC diagnoses was 40.2 (SD 1.2) years in Finland and 34.7 (SD 1.1) years in Poland.
CONCLUSIONS: A considerable proportion of causal HPV infections leading to OPC in men are acquired after age 26, indicating sustained HPV transmission and oncogenic risk beyond early adulthood. Long latency underscores the importance of considering mid-life HPV acquisition in prevention strategies, including catch-up vaccination targeting older males.
Conference/Value in Health Info
2026-11, ISPOR Europe 2026, Vienna, Austria
Value in Health, Volume 29, Issue 12S
Code
EE241
Topic
Economic Evaluation, Epidemiology & Public Health
Disease
Oncology