Trend in HPV-related hospitalization in years 2015-21 in a Southern Italian Region

BACKGROUND: The Human papillomavirus (HPV) is the most common cause of sexually transmitted infections in the general population. Genotypes are classified into two main class, high-risk and low-risk genotypes, according to their capacity to induce cancers. The low-risk class (types 6-11) is associated to anal and genital lesions. The high-risk is responsible for up to 4.5% of all new cancer cases yearly. The aim of this study was to evaluate the incidence of HPV-related hospitalizations and its trend in a Southern Italian Region in years 2015-2021. METHODS: It was a retrospective study performed in Abruzzo Region, Italy. All admissions performed during years 2015-2021 were extracted from the hospital discharge record. The study included genital warts, head-neck cancers, anal cancers, cervical cancers, genitourinary cancers and penile cancers. Annual hospitalization rates for each HPV-related disease were calculated per 100,000 inhabitants using the related attributable fractions. The Joinpoint model was used to evaluate the time trends of standardized rates and the average annual percent change (APC). RESULTS: During study period, totally 5492 HPV-related admissions were performed. The great part was related to cervical cancer (3386 cases) and to genital warts (638 cases). The great reduction was reported among genital warts, decreased from 8.5 admissions in 2015 to 5.9/100,000 in 2021 with APC of -8.03 (95%CI -11.91 - -0.33). The other most important reduction was referred to anal cancer (APC -4.79, 95%CI -16.91 -6.43) and genitourinary cancers (APC -3.72, 95%CI -11.21-7.20). Considering the first year of pandemic (year 2020), the great part of considered diseases reported a decrease, particularly among cervical cancer (PC -10.8 from 2019 to 2020). CONCLUSIONS: HPV-related hospitalizations decrease in Abruzzo during study period. These results could be useful to policy maker in improving vaccination coverage and screening adherence. KEY MESSAGES: • HPV-related hospitalizations represent a heavy burden for healthcare services. • During years 2015-21, a decrease in HPV-related hospitalizations was observed.