Updated estimate of the annual direct medical cost of screening and treatment for human papillomavirus associated disease in the United States

Vaccine. 2023 Mar 31;41(14):2376-2381. doi: 10.1016/j.vaccine.2023.02.049. Epub 2023 Mar 11.


The annual direct medical cost attributable to human papillomavirus (HPV) in the United States over the period 2004-2007 was estimated at $9.36 billion in 2012 (updated to 2020 dollars). The purpose of this report was to update that estimate to account for the impact of HPV vaccination on HPV-attributable disease, reductions in the frequency of cervical cancer screening, and new data on the cost per case of treating HPV-attributable cancers. Based primarily on data from the literature, we estimated the annual direct medical cost burden as the sum of the costs of cervical cancer screening and follow-up and the cost of treating HPV-attributable cancers, anogenital warts, and recurrent respiratory papillomatosis (RRP). We estimated the total direct medical cost of HPV to be $9.01 billion annually over the period 2014-2018 (2020 U.S. dollars). Of this total cost, 55.0% was for routine cervical cancer screening and follow-up, 43.8% was for treatment of HPV-attributable cancer, and less than 2% was for treating anogenital warts and RRP. Although our updated estimate of the direct medical cost of HPV is slightly lower than the previous estimate, it would have been substantially lower had we not incorporated more recent, higher cancer treatment costs.

Keywords: Cervical cancer; Cost; Health economics; Human papillomavirus; Intraepithelial neoplasia; Screening.

MeSH terms

  • Condylomata Acuminata* / diagnosis
  • Condylomata Acuminata* / epidemiology
  • Condylomata Acuminata* / therapy
  • Cost-Benefit Analysis
  • Early Detection of Cancer
  • Female
  • Health Care Costs
  • Human Papillomavirus Viruses
  • Humans
  • Papillomavirus Infections* / complications
  • Papillomavirus Infections* / diagnosis
  • Papillomavirus Infections* / epidemiology
  • Papillomavirus Vaccines* / therapeutic use
  • United States
  • Uterine Cervical Neoplasms* / diagnosis
  • Uterine Cervical Neoplasms* / prevention & control


  • Papillomavirus Vaccines

Supplementary concepts

  • Recurrent respiratory papillomatosis