Table 2.

Estimates of the annual direct medical costs of preventing and treating HPV-associated disease

Cost component	Number of cases		Cost per case (U.S. dollars)		Annual cost (millions, U.S. dollars)		Percent of cost burden
Cost component	Baseline	Range	Baseline	Range	Baseline	Range	Percent of cost burden
Cervical screening: routine	52 million	36 to 65 million	103	75 – 131	5,356	2,700 – 8,515	67.0%
Cervical screening: follow-up	NA	NA	NA	NA	1,224	617 – 1,946	15.3%
Cervical cancer	11,370	11,250 – 11,490	38,800	30,700 – 52,600	441	345 – 604	5.5%
Oropharyngeal cancer^*	7,080	5,620 – 8,430	43,200	20,100 – 61,200	306	113 – 516	3.8%
Anal cancer^*	4,270	3,950 – 4,460	36,200	17,500 – 70,200	155	69 – 313	1.9%
Vulvar cancer	1,560	1,130 – 1,990	23,600	15,500 – 31,700	37	18 – 63	0.5%
Vaginal cancer	460	310 – 590	27,100	20,300 – 34,100	12	6 – 20	0.2%
Penile cancer	360	260 – 470	19,800	9,800 – 38,800	7	3 – 18	0.1%
Genital warts^*	355,000	250,000 – 1,000,000	810	410 – 930	288	103 – 930	3.6%
Juvenile-onset RRP^*	820	80 – 1,560	150,000	72,000 – 387,000	123	6 – 604	1.5%
Adult-onset RRP^*	NA	NA	NA	NA	48	2 – 236	0.6%
Total burden					8,000	4,000 –13,800	100.0%

NA: not applicable (see text for details). RRP: recurrent respiratory papillomatosis.

Number of cases and cost per case are not presented for follow-up of cervical cancer screening and for adult-onset RRP because the total costs of follow-up and adult-onset RRP were calculated using previously-published estimates of the total costs of these outcomes. Cost per case estimates and ranges were obtained from Hu and Goldie (2008) for non-cervical cancers and from Insinga and colleagues (2008) and Kim and Goldie (2008) for cervical cancer [14–16]. The source studies on which the cost-per-case estimates for cancer were based used different methodologies. Although these estimates in general reflect the cost of diagnosis and treatment of cancer, the inclusion of other cost categories (e.g., follow-up, recurrence, terminal care) varied across the source studies such that the cancer cost estimates differ in their degree of completeness.[14–16] We did not include screening costs for non-cervical cancers owing to a lack of data on the number of people screened each year and/or the cost per person screened. See manuscript text and Table 1 for a description of other sources and assumptions.

Includes outcomes in males and females. Outcomes without asterisk are sex-specific.

Costs are reported in 2010 U.S. dollars.