BACKGROUND:Human papillomavirus (HPV) infection is a pre-requisite for cervical cancer, which represents the third most common cancer among women worldwide. A causal relationship also exists between HPV and cancer in other areas of the female reproductive system including the vagina and vulva. Whilst the incidence of vaginal cancer in the UK has remained relatively stable over the past 25 years, vulval cancer rates are increasing. A body of literature exists on the epidemiology and aetiology of vaginal and vulval cancer, but little is known about the economic burden. The objective of this study was to quantify the costs of treating these cancers on the National Health Service (NHS) in England. METHODS:Inpatient and outpatient episodes were derived from Hospital Episode Statistics (HES). Health Resource Group (HRG) tariffs and National Reference Costs were used to estimate the cost of treating pre-cancerous and invasive vaginal and vulval lesions in England. RESULTS:The study showed that for the 5 years from 2009/2010 to 2014/2015 the total cost associated with pre-cancerous and invasive vaginal and vulval lesions was over £14 million per year on average (95% of which was attributed to inpatient costs). Vulval cancer accounted for the largest proportion; an estimated 60% of the total cost (£8.82 million). On average 4316 patients per year in England were admitted to hospital and 912 patients attended outpatient settings for pre-cancerous and invasive disease of the vagina and vulva. CONCLUSION:The results indicate that vaginal and vulval cancer cost the English health care system over £14 million per year. Given the causal role of HPV in a proportion of these cancers, preventative measures such as the national HPV immunisation programme have the potential to reduce the economic burden. To ensure optimal use of NHS resources, it is important that future economic evaluations of such preventative measures consider the full burden of HPV related disease.

译文

背景:人类乳头瘤病毒(HPV)感染是宫颈癌的先决条件,它是全球女性中第三大最常见的癌症。在女性生殖系统的其他区域(包括阴道和外阴)中,HPV与癌症之间也存在因果关系。在过去的25年中,英国阴道癌的发病率一直保持相对稳定,但外阴癌的发病率却在上升。关于阴道和外阴癌的流行病学和病因学,已有大量文献报道,但对其经济负担知之甚少。这项研究的目的是量化英格兰国家卫生局(NHS)治疗这些癌症的费用。
方法:住院和门诊发作均来自《医院发作统计》(HES)。使用卫生资源集团(HRG)的关税和国家参考成本来估算英格兰治疗癌前病变和侵入性阴道及外阴病变的成本。
结果:研究表明,从2009/2010年到2014/2015年的5年中,与癌前和浸润性阴道和外阴病变相关的总费用平均每年超过1400万英镑(其中95%归因于住院费用)。外阴癌所占比例最大。估计占总成本的60%(882万英镑)。在英格兰,平均每年有4316名患者入院,有912名患者因阴道和外阴癌前性和浸润性疾病就诊。
结论:结果表明,阴道和外阴癌每年使英国卫生保健系统损失超过1400万英镑。鉴于HPV在这些癌症中的一部分具有因果作用,因此预防措施(如国家HPV免疫计划)有可能减轻经济负担。为了确保最佳利用NHS资源,对此类预防措施的未来经济评估必须考虑与HPV相关疾病的全部负担,这一点很重要。

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