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Excess Cancer Cases and Medical Costs Due to Suboptimal Human Papillomavirus Vaccination Coverage in California

Baughan, Eleonore B. BS*; Keizur, Erin M. BS; Damico, Christopher A. BS; Arnold, Elizabeth Mayfield PhD; Ko, Jamie S. BS, MPH; Klausner, Jeffrey D. MD, MPH

doi: 10.1097/OLQ.0000000000001016
Original Studies

Background Human papillomavirus (HPV) vaccination coverage continues to be at low to moderate levels throughout the United States. HPV infection is linked to multiple types of cancers resulting in high economic and health burden. We aimed to estimate the excess number of cancer cases and associated medical costs due to current HPV vaccination coverage for a 20-year-old birth cohort in California.

Methods We estimated the lifetime number of cancer cases caused by vaccine-preventable strains of HPV for a cohort of 20 year-olds in California. We then estimated the excess number of cancer cases in that cohort which would occur due to 2017 HPV vaccination coverage compared with an optimal coverage of 99.5%. By multiplying those excess cases by the average cost of treatment, we determined the excess cost due to current HPV vaccination coverage.

Results With current vaccination coverage in California, the 20-year-old cohort is at risk for an excess 1352 cancer cases that could be prevented with a projected optimal vaccination coverage of 99.5%. The excess cost of treatment for those cancer cases would be US $52.2 million. Male oropharyngeal cancer accounts for the greatest projected cost burden US $21.3 million followed by cervical cancer US $16.1 million.

Conclusions Increased HPV vaccination coverage in California is needed to reduce economic and health burdens associated with cancers caused by HPV infection.

Suboptimal human papillomavirus vaccination coverage in California contributes to a significant economic and health burden from cancer, which could be avoided with increased vaccination coverage.

From the *Cornell University, Division of Nutritional Sciences, Ithaca, NY;

University of California, Division of Infectious Diseases, Los Angeles, CA; and

UT Southwestern Medical Center, Department of Family and Community Medicine, Dallas, TX

Correspondence: Eleonore Baughan, BS, University of California, Los Angeles 10920 Wilshire Boulevard Suite 350 Los Angeles, CA 90024 E-mail:

Conflict of Interest: None declared.

Acknowledgments: This study was supported in part by Team Klausner Saving Lives and National Institutes of Health: Center for AIDS Research 5P30AI028697.

Received for publication February 13, 2019, and accepted May 3, 2019.

Online date: June 11, 2019

© Copyright 2019 American Sexually Transmitted Diseases Association