Article Text

Quality of life valuations of HPV-associated cancer health states by the general population
  1. E Lynne Conway1,
  2. K Chip Farmer2,
  3. William J Lynch3,
  4. Guy L Rees4,
  5. Gerard Wain5,
  6. Jane Adams6
  1. 1CSL Biotherapies, Parkville, Victoria, Australia
  2. 2Colorectal Surgery, The Alfred Hospital, Melbourne, Victoria, Australia
  3. 3Urology Sydney, The St George Hospital, Kogarah, New South Wales, Australia
  4. 4Oral Pathology, Dental School, The University of Adelaide, Adelaide, South Australia, Australia
  5. 5Gynaecological Oncology, Westmead Hospital, Westmead, New South Wales, Australia
  6. 6Pretium Pty Ltd, Sydney, New South Wales, Australia
  1. Correspondence to Dr E Lynne Conway, CSL Biotherapies, 45 Poplar Road, Parkville, VIC 3052, Australia; lynne.conway{at}


Objectives To obtain health-related quality of life valuations (ie, utilities) for human papillomavirus (HPV)-related cancer health states of vulval, vaginal, penile, anal and oropharyngeal cancers for use in modelling cost-effectiveness of prophylactic HPV vaccination.

Methods Written case descriptions of each HPV-associated cancer describing the ‘average’ patient surviving after the initial cancer diagnosis and treatment were developed in consultation with oncology clinicians. A general overview, standard gamble questionnaire for each health state and a quiz was conducted in 120 participants recruited from the general population.

Results In the included population sample (n=99), the average age was 43 years (range = 18–70 years) with 54% men, 44% never married/43% married, 76% education beyond year 12 and 39% employed full-time. The utility values for the five health states were 0.57 (95% CI 0.52 to 0.62) for anal cancer, 0.58 (0.53 to 0.63) for oropharyngeal cancer, 0.59 (0.54 to 0.64) for vaginal cancer, 0.65 (0.60 to 0.70) for vulval cancer and 0.79 (0.74 to 0.84) for penile cancer. Participants demonstrated a very good understanding of the symptoms, diagnosis and treatment of these cancers with a mean score of 9 (SD=1.1) on a 10-item quiz.

Conclusions This study provides utility estimates for the specific HPV-related cancers of vulval, vaginal, penile, anal and oropharyngeal cancers valued by a general population sample using standard gamble. The results demonstrate considerable quality of life impact associated with surviving these cancers that will be important to incorporate into modelling cost-effectiveness of prophylactic HPV vaccination in different populations.

  • Anogenital cancer
  • HPV
  • attitudes
  • oncology
  • oral cavity
  • oral sex
  • vaccination

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: and

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  • Funding This study was funded by CSL Biotherapies, a subsidiary of CSL Limited. CSL Limited is a financial beneficiary of sales of Gardasil and Cervarix; CSL Biotherapies distributes Gardasil in Australia and New Zealand.

  • Competing interests ELC is an employee of CSL Biotherapies and also owns shares in CSL Limited. JA is an employee of Pretium, a consultancy engaged by CSL Biotherapies to undertake the study. GW has been involved in the research studies for Gardasil and has acted as a consultant and received honoraria for speaking from Merck and CSL Biotherapies. He received no financial compensation for this study. WJL has acted as a consultant for CSL Biotherapies. He received no financial compensation for this study.

  • Provenance and peer review Not commissioned; externally peer reviewed.