Burden of Human Papilloma Virus - Associated Cancers Among Men in Ecuador, 2015-2019.

Objectives
In Latin America, the human papillomavirus (HPV) attributable fraction (AF) in cancers of the penis, anus, and head and neck (H&N) are estimated in 50%, 88%, and 25%, respectively. The HPV-AF of these cancers could be eliminated if HPV infection is prevented (e.g.vaccination). In Ecuador, the HPV vaccination program targets only 9-10-year girls. Since data on HPV-associated cancer burden in men are not available in Ecuador, we assessed real-world evidence using local databases.
Methods
This was a retrospective observational study using the national hospital discharge and mortality databases of Ecuador. All hospitalizations for cancers most likely to be HPV-associated (penis, anus, and selected sites of head and neck [oropharynx/oral cavity/larynx]) in men ≥ 18years were identified using the International Classification of Diseases (ICD-10) from 2015 to 2019. The main variables were hospitalization rate, length of stay (LOS), age at discharge, and mortality rate. The mortality rate was calculated using the male population at risk.
Results
From 2015-2019, 4,880 hospitalizations occurred among men with anal/penile/selected H&N cancers (on average 976 hospitalizations/year). The average hospitalization rate combined for all these cancers were 18.4/100,000. The average LOS was 5.8, 6.8, 6.1, 6.6, 5.6 and 5.9 days for anal, penile, H&N, larynx, oral cavity and oropharynx respectively. The mean age (±SD) at hospitalization was 59.3(±15.6), 58.2(±17.3), 61.7(±14.0), 64.5(±12.7), 61.2(±15.0) and 58.3(±13.8) for anal, penile, H&N, Larynx, oral cavity and oropharynx respectively. Overall cancer mortality for all cancers studied was 2.5 deaths/ 100,000 men, totalizing 1,162 deaths. The mortality rate for anal, penile, H&N, larynx, oral cavity and oropharynx was 0.1/100,000, 0.5/100,000, 1.9/100,000, 1.0/100,000, 0.4/100,000 and 0.5/100,000 respectively.
Conclusions
Local databases provided valuable real-world evidence on the use of hospital resources and the burden of HPV-associated cancer in men. Considering local/regional HPV-AF, estimates can be obtained to inform health public policies in men.