OBJECTIVES

To estimate the incidence and cost of HPV-associated cancer in Korea and observe the trend.

METHODS

This population-based, retrospective cohort study used Korean National Health Insurance (NHI) claim database from 2011 to 2017. Patients primarily or secondarily diagnosed with vaginal (C52), vulvar (C51), anal (C21), penile (C60), base of tongue (C01), tonsil cancer(C09) and oropharyngeal cancer (C10) were included in the analysis. The index date corresponded to the first diagnosis of the case. After incorporating 2-year washout period before diagnosis and one-year follow period subsequent to diagnosis, 2013~2016 were used as index periods. The main outcome measures were number of incident cancers and annual costs per case since their first diagnosis, which were adjusted by the medical care component of the Consumer Price Index in 2016. Costs reimbursed by NHI, which include pharmaceuticals, outpatient visits, as well as hospitalization, were included.

RESULTS

During study period, 8705 cases were identified with a total of 476 vaginal, 608 vulvar, 2981 anal, 263 penile, 1021 base of tongue, 1965 tonsil, and 1391 oropharyngeal cancers, respectively. The total incidence cost of HPV-associated cancers increased from USD 31,035,236 in 2013 (in 2016 USD) to USD 43,385,866 USD in 2016. Specifically, the average cost per case in 2016 USD was 18,806 USD for vaginal, 13,074 USD for vulvar, 16,056 USD for anal, 10,188 for penile, 21,396 USD for base of tongue, 23,055 USD for tonsil, 20,303 USD for oropharyngeal cancers, respectively. Higher incidence rates were observed among males compared with females, with incidence rates per 100,000 for males vs. females being 0.7 vs. 0.25 for base of Tongue, 1.6 vs. 0.35 for tonsil, and 1.1 vs. 0.2 for oropharyngeal cancer, respectively.

CONCLUSIONS

HPV-associated cancers impose substantial burden in Korea.