Landscape assessment for gender neutral human papillomavirus vaccination recommendations including head and neck cancer burden data

• Published in: Vaccine Vol. 39; no. 39; pp. 5461 - 5473
• Main Authors: Morais, Edith, El Mouaddin, Nadia, Schuurman, Susanne, De, Atish
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier Ltd 15.09.2021; Elsevier Limited
• Subjects: Allergy and Immunology; Alphapapillomavirus; Cancer; cost effectiveness; Economic impact; Economics; Epidemiology; Evaluation; Female; Gender; Gender Neutral Vaccination; Head & neck cancer; Head and Neck Neoplasms - epidemiology; Head and Neck Neoplasms - prevention & control; HPV; HPV related Head and Neck Cancers; Human papillomavirus; Humans; Immunization; Impact analysis; Internet; landscapes; Larynx; Literature reviews; Male; Males; Men; mortality; mouth; Oral cancer; Oral cavity; Papillomaviridae; Papillomavirus Infections - epidemiology; Papillomavirus Infections - prevention & control; Papillomavirus Vaccines; Technology assessment; Throat cancer; Vaccination; Vaccines; Websites; Womens health; United Kingdom > UK; United States > US; HPV related Head and Neck Cancers; Gender Neutral Vaccination; HPV
• ISSN: 0264-410X; 1873-2518; 1873-2518
• DOI: 10.1016/j.vaccine.2021.08.043

•To our knowledge, this is the first study assessing head and neck cancer (HNC) data in health technology assessment (HTA) agencies and National Immunization Technical Advisory Groups (NITAGs) evaluation reports.•Human Papillomavirus (HPV) is a known risk factor for many HNC, especially oropharyngeal cancers (OPC), and, unlike other risk factors such as smoking, an increase in the incidence of HPV-related HNC has been observed in recent decades among men.•In the few HTA and NITAGs assessments known to assess HPV gender neutral vaccination (GNV), many only consider OPC and do not explore the wider burden of HNC.•Although some HNC data are currently available and used by HTA agencies and NITAGs, further research needs to be conducted to obtain updated and local data. Head and neck cancers (HNC) accounted for over 450,000 deaths and 900,000 cases in 2018 worldwide. Of those, 38,000 cases were attributable to human papillomavirus (HPV). HNC is two to four times more prevalent in men than in women. The incidence of oropharyngeal cancers (OPC) and oral cavity cancers caused by HPV has increased in recent decades. Given the substantial burden of HPV-related HNC in males, this study aimed to assess whether and how national agencies included HPV-related HNC when evaluating HPV genderneutral vaccination (GNV) programs. A systematic literature review was conducted in MEDLINE® and EMBASE®, and on the websites of selected national agencies. Searches identified a potential 205 records; seventeen were eligible for the review. Seventy percent of assessments were published by European countries and most were recent (2014–2019). Eleven (65%) reports considered OPC when discussing HNC, and a few included other anatomic sites. All reports that considered incidence data were in consensus that incidence of OPC was higher in men and showed that the mortality rates for HPV-related HNC were also higher in men. When looking at the economic impact, the incremental cost-effectiveness ratios in the assessments varied widely, as the inputs into the analyses were heterogeneous. However, several reports concluded GNV programs were likely to be cost-effective versus not vaccinating males. The burden of HPV-related HNC in the general male population has been recognized by several Heatlth Technology Assessment (HTA) agencies and National Immunization Technical Advisory Groups (NITAGs) when evaluating HPV GNV programs. The assessments identified on GNV programs strongly indicate a cost-effective clinical benefit. Nevertheless, the epidemiological burden of HNC may have been underestimated in some countries due to limited data. Further research is crucial to obtain more robust data that will help address the information gap in epidemiological and economic burden of HPV-associated HNC in men.