The indirect costs and burden of vaccine-preventable cancers premature mortality in Asia-Pacific countries

Cancer is the second leading cause of death in the Asia-Pacific region. Human papillomavirus (HPV) and hepatitis B virus (HBV) are major cancer-causing infections. This analysis assessed the mortality impact and productivity losses due to HBV- and HPV-related cancers in ten Asia-Pacific countries. Number of deaths and years of life lost (YLL) in 2019 were sourced from the Institute for Health Metrics Evaluation Global Burden of Disease for the following: HBV-related liver cancer, and HPV-related oral cavity, larynx, oropharynx, and cervical cancers (other HPV-related cancers were not included). Ten countries from the Asia-Pacific region were included. Attributable fractions of HPV-related cancers were applied. Average YLL (AYLL) was calculated as the average number of years a person would have lived if they had not died prematurely. The value of YLL (VYLL) was estimated using GDP per capita and YLL. Discount rate of 3% was applied to adjust future health losses to present value. Sensitivity and scenario analyses were also conducted to assess the robustness of the results. In 2019, 52,796 deaths and 1,493,438 YLL were caused by HBV- and HPV-related cancer in the selected Asia-Pacific countries, incurring a productivity loss of $15 billion. Liver cancer accounted for 62.2% of the total productivity loss followed by cervical cancer (35.5%). The Asia-Pacific region had an AYLL of 28, with values ranging from 21 (Japan) to 34 (Philippines). Republic of Korea had the highest productivity losses followed by Japan and Thailand ($5.6, $4.3 and $1.8 billion, respectively). The Asia-Pacific region bears a significant economic burden from potentially vaccine-preventable cancers. Enhanced public health measures, including screening and expanded HBV and HPV vaccination coverage, could alleviate this burden.