Ekwueme Donatus U, Chesson Harrell W, Zhang Kevin B, Balamurugan Appathurai
Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia 30341, USA.
Cancer. 2008 Nov 15;113(10 Suppl):2936-45. doi: 10.1002/cncr.23761.
Although years of potential life lost (YPLL) and mortality-related productivity costs comprise a substantial portion of the burden of cancers where human papillomavirus (HPV) may be a risk factor for carcinogenesis (called HPV-associated cancers in this report), estimates of these costs are limited. The authors estimated the mortality-related burden (in terms of YPLL and productivity costs) of HPV-associated cancers (without regard to the percentage of each of these cancers that could be attributed to HPV) and all malignant cancers in the United States in 2003.
The authors used 2003 national mortality data and US life tables to estimate YPLL for HPV-associated cancers and all malignant cancers. YPLL was estimated by using the life expectancy method. The human capital approach was used to estimate the value of the expected future lifetime productivity losses caused by premature deaths from HPV-associated cancers and all malignant cancers. Indirect mortality costs were estimated as the product of the number of deaths and the expected value of individuals' future earnings, including an imputed value of housekeeping services.
In 2003, HPV-associated cancers accounted for 181,026 YPLL, which represented 2.4% of the estimated 7.5 million YPLL attributable to all malignant cancers in the United States. The average number of YPLL was 21.8 per HPV-associated cancer death and 16.3 per death from overall malignant cancers. Overall, HPV-associated cancers had the largest relative contribution to YPLL in women ages 30 to 34 years. The lifetime productivity cost from mortality in 2003 was $3.7 billion for HPV-associated cancer mortality and $133.5 billion for overall malignant cancer mortality.
HPV-associated cancers impose a considerable burden in terms of premature deaths and productivity losses.
尽管潜在寿命损失年数（YPLL）以及与死亡率相关的生产力成本在癌症负担中占了很大一部分，而人乳头瘤病毒（HPV）可能是这些癌症致癌的一个风险因素（本报告中称为HPV相关癌症），但对这些成本的估计却很有限。作者估算了2003年美国HPV相关癌症（不考虑这些癌症中可归因于HPV的比例）和所有恶性肿瘤的与死亡率相关的负担（以YPLL和生产力成本衡量）。
作者使用2003年全国死亡率数据和美国生命表来估算HPV相关癌症和所有恶性肿瘤的YPLL。YPLL采用预期寿命法估算。人力资本法用于估算HPV相关癌症和所有恶性肿瘤过早死亡导致的未来预期终身生产力损失的价值。间接死亡成本估算为死亡人数与个人未来收入预期价值的乘积，包括家务服务的估算价值。
2003年，HPV相关癌症导致181,026个潜在寿命损失年数，占美国所有恶性肿瘤所致约750万个潜在寿命损失年数的2.4%。HPV相关癌症每例死亡的平均潜在寿命损失年数为21.8年，所有恶性肿瘤每例死亡的平均潜在寿命损失年数为16.3年。总体而言，HPV相关癌症在30至34岁女性中对潜在寿命损失年数的相对贡献最大。2003年，HPV相关癌症死亡导致的终身生产力成本为37亿美元，所有恶性肿瘤死亡导致的终身生产力成本为1335亿美元。
HPV相关癌症在过早死亡和生产力损失方面造成了相当大的负担。
