Hospitalization and mortality burden of human papillomavirus-associated cancers among men in Ecuador: a nationwide population-based study

Introduction Human papillomavirus (HPV)-associated cancers in men contribute substantially to cancer-related morbidity and mortality, yet population-based evidence from Latin America remain limited, particularly in Ecuador. Materials and methods Using nationwide hospital discharge and mortality databases from Ecuador for 2015–2019, this retrospective secondary data analysis quantified the burden of HPV-associated cancers among men and estimated the HPV-attributable burden using published site-specific attributable fractions. Crude and age-specific rates were calculated, and age-standardized rates (ASRs) were obtained using the World Health Organization (WHO) World Standard Population. Results During 2015–2019, 3,442 hospitalizations due to HPV-associated cancers were recorded (ASR: 9.7 per 100,000 men), with head and neck cancers accounting for 66.4% of hospitalizations, followed by penile cancer (24.0%) and anal cancer (9.6%). Although hospitalization and mortality rates increased markedly with age, more than half of hospitalizations and approximately one-third of deaths from oropharyngeal, penile, and anal cancers occurred among men aged <60 years. Applying published site-specific attributable fractions, 1,002 hospitalizations were estimated to be HPV-attributable (ASR: 2.8 per 100,000 men), with penile cancer contributing the largest share. A total of 575 deaths due to HPV-associated cancers were identified (ASR: 1.7 per 100,000 men), of which 134 were estimated to be HPV-attributable (ASR: 0.4 per 100,000 men). Mortality rates increased progressively with age. Conclusion HPV-associated cancers impose a substantial hospitalization and mortality burden among men in Ecuador. Although the highest burden was observed among older adults, a considerable burden was also evident among men aged <60 years. These findings provide a national baseline for surveillance and may inform future evaluations of HPV prevention strategies, alongside efforts to achieve high and equitable HPV vaccination coverage, earlier diagnosis, timely treatment, and improved access to cancer care.