Impact of HPV Vaccination on Morbidity and Mortality in Italian Women

The Dangers of HPV

Human papillomavirus (HPV) is a significant factor in the development of various cancers, including those of the vagina, vulva, penis, anus, and head and neck. Additionally, HPV can cause nonmalignant conditions such as anogenital warts and recurrent respiratory papillomatosis. Cervical cancer, most notably associated with HPV, ranks as the fourth most common cancer among women, with 528,000 new cases and 266,000 deaths reported in 2012.

HPV Vaccine Research

Currently, two vaccines, Gardasil® and Cervarix®, are approved for preventing the transmission and infection of specific HPV strains. While substantial data exists on the efficacy of these vaccines in preventing HPV infection, research specifically examining the impact of HPV vaccination on morbidity (disease rates) and mortality (deaths) in Italian women has been limited.

A recent study published in *Population Health Metrics* assessed the effects of HPV vaccination on women’s health in Italy. The researchers developed a model comprising various disease states and transitions, including healthy status, genital warts, grade 1 and grade 2/3 cervical intraepithelial neoplasia, cervical cancer, anal cancer, and death. This model was informed by existing literature on HPV and associated diseases, along with Italian life tables. Researchers estimated multiple indicators to evaluate the impact of disease and vaccination on health, including life expectancy, quality-adjusted life years (QALY), Disability-Adjusted Life Years (DALY), and attributable risk (AR).

HPV Vaccines and Quality of Life

The study’s model revealed that life expectancy for a theoretical cohort of 100,000 Italian women was 83.1 years, which improved to 83.2 years with HPV vaccination. The QALYs for the non-intervention group stood at 82.7 years, while those in the HPV vaccination group were at 82.9 years. This indicates that HPV-related diseases diminish women’s overall health by an estimated 0.35 years.

Moreover, DALYs, which encompass both the quality and quantity of life lost due to mortality and disability, decreased by 0.6 years with HPV vaccination. The attributable risk, reflecting the incidence of HPV-related disease in vaccinated versus non-vaccinated groups, was 145 per 100,000 in the vaccinated group compared to 265 per 100,000 in the unvaccinated group.

This research represents the first attempt to model the long-term effects of the HPV vaccine on women’s health in Italy. Although the overall impact of HPV vaccination on mortality among Italian women was found to be minimal, the vaccine significantly reduced the incidence of HPV-related diseases. This reduction may lead to lower healthcare costs and less economic burden from lost productivity, highlighting the broader benefits of vaccination.

HPV Vaccination Proves Beneficial

Despite the model’s inherent simplifications, such as a limited range of disease states and simplified assumptions about disease transitions, its findings are valuable for estimating the long-term impact of HPV vaccination within a population.

References

1. World Health Organization. Human Papillomavirus. Updated: February 7, 2017. Accessed: October 08, 2017. http://www.who.int/immunization/diseases/hpv/en/
2. Marcellusi, A. Impact of HPV vaccination: Health gains in the Italian female population. Popul Health Metrics 15, 36 (2017). https://doi.org/10.1186/s12963-017-0154-0