Productivity costs due to human papillomavirus-related cancer mortality in the United Kingdom

Figures & data

Table 1. Population attributable fractions applied for HPV-related cancers.

Cancer	Population attributable fraction
Oral cavity and pharynx	0.091*
Larynx	0.024
Cervical	1.000
Vulval	0.249
Vaginal	0.780
Anal	0.880
Penile	0.500

Source: de Martel et al.²³

* PAF for oral cavity and pharynx cancer was calculated by weighting de Martel et al. 2017 AFs by the proportion of incidence for oral cavity, nasopharynx, oropharynx, hypopharynx, and pharynx cancer.

Abbreviations: HPV, Human papillomavirus; IHME, Institute for Health Metrics Evaluation; PAF: Population attributable fraction.

Table 2. Parameter assumptions made in the model.

Model settings	Assumption details	Source
Age-groups	Individuals within each age-group were assumed to be homogenous and will have the same outcomes. Individuals in the 0–14 years age group were assumed to be in full-time education and therefore have no income.*	National Cancer Registry and Analysis Service (NCRAS)^17 Public Health Scotland^18 Public Health Wales^19 Northern Ireland Cancer Registry^20
Retirement ages	Individuals in an age-group above the average retirement had no years of productive life to lose.	The World Bank21
Income	Average wage was assumed to be equal across age groups and countries of the UK.	Eurostat database 2018^24
Labor force participation	Labor force participation was assumed to be equal across age groups.	The World Bank^25
Attributable fractions	Assumed to be homogenous across age-groups and countries of the UK. Infection was not assumed to impact the prognosis of cancer. PAFs were based on the proportion of cancer cases attributable to HPV, which may not be proportional to the number of cancer deaths attributable to infection.	De Martel et al. 2017^23

* The youngest age group in the dataset was 0–14 years, with the next group being 15–39 years. In order to avoid additional assumptions to delineate the number of individuals aged 15 and 16 within the 15–39 group, only those in the 0–14 year group were assumed to be in full time education. Individuals aged 14–16 years in the UK must still be in full time education, however they may also undertake part-time work.

PAF: population attributable fraction; UK: United Kingdom.

Table 3. Number of cancer deaths related to HPV, by cancer type and by sex, in 2019.

Cancer	Number of deaths
	Male	Female	Total
Head and neck cancer	217	100	318
Cervical	–	844	844
Vulval	–	108	108
Vaginal	–	90	90
Anal	206	176	382
Penile	76	–	76
Total HPV-related	499	1318	1817

The number of cancer deaths attributable to HPV infection were estimated by applying population attributable fractions for each anatomic location to mortality inputs.

Abbreviations: HPV: human papillomavirus.

Table 4. YLL and YPLL related to HPV, by cancer type and by sex, in 2019.

Cancer	YLL			YPLL			YLL per death
	Male	Female	Total	Male	Female	Total	Male	Female	Total
Head and neck	2557	1495	4051	724	338	1062	12	13	13
Cervical	–	19,823	19,823	–	8771	8,771	–	23	23
Vulval	–	1185	1185	–	195	195	–	11	11
Vaginal	–	1214	1214	–	271	271	–	13	13
Anal	2280	1495	4051	684	583	1268	11	14	12
Penile	797	–	797	199	–	199	11	–	11
Total HPV-related	5634	26,170	31,804	1607	10,158	11,765	11	20	18

The number of cancer deaths attributable to HPV infection were estimated by applying population attributable fractions for each anatomic location to mortality inputs.

Abbreviations: HPV, Human papillomavirus; YLL, Years of life lost; YPLL; Years of productive life lost.

Table 5. PVFLP related to HPV by cancer type across UK countries in 2019.

Cancer	England	Scotland	Wales	Northern Ireland	UK total
Head and neck	£19,124,703	£2,820,300	£1,149,497	£726,551	£23,821,052
Cervical	£100,630,889	£14,535,396	£6,852,840	£3,334,740	£125,353,865
Vulval	£2,600,286	£610,845	£130,613	£ -	£3,341,744
Vaginal	£3,478,937	£744,704	£286,611	£ -	£4,510,251
Anal	£22,022,152	£2,202,749	£1,445,242	£ -	£25,670,143
Penile	£4,739,318	£211,115	£117,489	£ -	£5,067,922
Total HPV-related	£152,596,285	£21,125,109	£9,982,293	£4,061,291	£187,764,978

Note: There was a lack of data reporting for less prevalent cancers (penis, anus, vagina, vulva) in Northern Ireland. The number of cancer deaths attributable to HPV infection were estimated by applying population attributable fractions for each anatomic location to mortality inputs.

Abbreviations: HPV, Human papillomavirus; PVFLP, Present value of future lost productivity; UK, United Kingdom.

Figure 1. YLL per death related to HPV by cancer type in each UK country. There was a lack of data reporting for less prevalent cancers (penis, anus, vagina, vulva) in Northern Ireland. The number of cancer deaths attributable to HPV infection were estimated by applying population attributable fractions for each anatomic location to mortality inputs. Abbreviations: HPV, Human papillomavirus; YLL, Years of life lost.

Table 6. PVFLP related to HPV by cancer type and by sex in the UK in 2019.

Cancer	Male	Female	Total
Head and neck	£18,092,899	£5,728,153	£23,821,052
Cervical	£ -	£125,353,865	£125,353,865
Vulval	£ -	£3,341,744	£3,341,744
Vaginal	£ -	£4,510,251	£4,510,251
Anal	£16,222,371	£9,447,772	£25,670,143
Penile	£5,067,922	£ -	£5,067,922
Total HPV-related	£39,383,192	£148,381,786	£187,764,978

Note: The number of cancer deaths attributable to HPV infection were estimated by applying population attributable fractions for each anatomic location to mortality inputs.

Abbreviations: HPV, Human papillomavirus; PVFLP, Present value of future lost productivity; UK, United Kingdom.

Figure 2. Tornado diagram for PVFLP in 2019. Abbreviations: PAF, Population attributable fraction; PVFLP, Present value of future lost productivity; UK, United Kingdom.

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Data availability statement

The authors confirm that the data supporting the findings of this study are available within the article and its supplementary materials where links are available to the publicly available datasets used.