Implementing a gradual, catch-up HPV vaccination program can yield considerable long-term public health benefits by reducing the future burden of both cervical and oropharyngeal cancers in Singapore, according to local research.
The catch-up program, which modelled a phased increase in vaccination coverage from a baseline of 15 percent to 90 percent over 15 years, targeting cohorts of individuals aged ≥17 years who were not covered by Singapore’s 2019 school-based program, was projected to lower the population-weighted mean prevalence of HPV to below 1 percent. [Vaccine 2026;doi:10.1016/j.vaccine.2026.128513]
A mean of 164,968 cervical cancer cases and 4,007 oropharyngeal cancer cases could be averted over the cohort’s lifetime (100 years), corresponding to a total gain of 120,919 health-adjusted life years (HALYs) across both cancers.
The findings align with those of models from the UK and the Netherlands, which projected similar reductions in cervical cancer incidence following the introduction of national vaccination programs. [Br J Cancer 2007;96:143-150; J Infect Dis 2016;214:854-862]
“However, our study provides a specific projection for Singapore, a context with a different epidemiological baseline and a more recent, highly successful school-based program. Unlike many earlier models that focused exclusively on cervical cancer, our inclusion of oropharyngeal cancer provides a more comprehensive evaluation of the vaccination program,” the authors noted. “This is particularly relevant given the rising incidence of HPV-positive OPC observed in many high-income settings.”
Policy and economic implications
The authors noted that the findings have immediate policy implications for Singapore’s alignment with the WHO Global Strategy for cervical cancer elimination.
While the local school-based program has already achieved the 90-percent HPV vaccination target for adolescent cohorts, a systematic catch-up program can extend coverage to older populations, which represents the critical next step to accelerate elimination-level incidence thresholds, they said.
“Beyond the direct health gains quantified in HALYs, the averted cancer cases projected in our simulation imply substantial economic benefits. HPV-related cancers, like other malignancies, impose significant economic burdens through both direct medical costs and indirect costs, such as productivity losses,” the authors pointed out.
Cervical and oropharyngeal cancers often occur during the prime working years of affected individuals. This results in work absenteeism, reduced productivity, and premature mortality, all of which contribute to considerable losses to the economy. [Front Public Health 2020;8:624092]
“While our study did not formally model these economic outcomes, the 169,000 combined cancer cases averted under the gradual catch-up scenario would translate to a significant reduction in these productivity losses, representing a major return on investment for the national vaccination program,” the authors explained.
Future economic evaluations are needed to “capture the full societal value of HPV vaccination,” they added.