{
  "abstract": "Introduction: The link between Human Papillomavirus (HPV) and cancer is well-established. In Singapore, bivalent HPV vaccines are subsidised for females, but not males. Economic analysis of HPV vaccination has generally assessed the costs to the health system, but this may not be as relevant to individual decision-making as potential lost income. We estimated the impact of bivalent HPV 16/18 vaccination on sick leave, unemployment, and premature mortality as a function of age and sex to understand the broader impact of HPV-related cancers. Methods: We developed a population-level economic model to estimate lifetime income losses by diagnosis age, sex and cancer type. We applied sex- and cancer-specific Cox regressions to the Singapore Cancer Registry for annual predicted survival from 1992 to 2022. These were combined with census and employment data to estimate HPV-associated income losses in Singapore. Attributable fractions and vaccine effectiveness data for HPV 16/18 from the literature were used to estimate the effectiveness of bivalent HPV vaccination. Structural sensitivity analysis examined the role of 80% population coverage conferring herd immunity. Results: The registry contained 17,294 individuals with an HPV-associated cancer diagnosis. Lost income was greatest for cervical cancer due to its high prevalence, however the losses per diagnosis were highest for oropharyngeal cancer. Bivalent HPV vaccination led to income benefits of $SGD1,397 [$895 to $1,838] in girls and -$62 [-$76 to -$48] in boys. A gender-neutral HPV vaccination of 80% of 15-year-old Singaporeans, conferring herd immunity, would have lifetime income protective benefits of $24.4m [$14.2m, $33.7m] per cohort, a five-fold return on investment. Conclusions: In addition to avoiding healthcare costs and lost quality of life, parents should consider vaccination as a means of avoiding potential income losses. A national policy of gender-neutral HPV vaccination could deliver substantial income protection due to both individual vaccine protection and herd immunity.",
  "abstract_shown": true,
  "affiliations": [
    "Programme in Health Services Research & Population Health, Duke-NUS Medical School, Singapore, Singapore.",
    "National Dental Research Institute Singapore, National Dental Centre Singapore, Singapore, Singapore.",
    "Department of Head and Neck Surgery, National Cancer Centre Singapore, Singapore, Singapore.",
    "Oral Health Academic Clinical Programme, Duke-NUS Medical School, Singapore, Singapore."
  ],
  "article_type": "Research Article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Robin Blythe",
      "orcid": "0000-0002-3643-4332"
    },
    {
      "affs": [
        0
      ],
      "name": "Nicholas Graves"
    },
    {
      "affs": [
        2
      ],
      "name": "N Gopalakrishna Iyer"
    },
    {
      "affs": [
        0,
        1,
        3
      ],
      "name": "Marco A Peres"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/fk5wvvq2zrmfe.bib",
  "cited_by": 0,
  "doi": "10.1371/journal.pone.0361921",
  "fulltext_url": "https://europepmc.org/articles/PMC13722152",
  "id": "fk5wvvq2zrmfe",
  "issns": [
    "1932-6203"
  ],
  "landing_url": "https://doi.org/10.1371/journal.pone.0361921",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Biology and Life Sciences"
    ],
    [
      "heading",
      "Biology and life sciences"
    ],
    [
      "heading",
      "Cancer Detection and Diagnosis"
    ],
    [
      "heading",
      "Cancer Prevention"
    ],
    [
      "heading",
      "Cancer Vaccines"
    ],
    [
      "heading",
      "Cancers and Neoplasms"
    ],
    [
      "heading",
      "Carcinoma"
    ],
    [
      "heading",
      "Cervical Cancer"
    ],
    [
      "heading",
      "DNA viruses"
    ],
    [
      "heading",
      "Diagnostic Medicine"
    ],
    [
      "heading",
      "Genitourinary Tract Tumors"
    ],
    [
      "heading",
      "Gynecological Tumors"
    ],
    [
      "heading",
      "Human Papillomavirus"
    ],
    [
      "heading",
      "Immunology"
    ],
    [
      "heading",
      "Medical Microbiology"
    ],
    [
      "heading",
      "Medicine and Health Sciences"
    ],
    [
      "heading",
      "Microbial Pathogens"
    ],
    [
      "heading",
      "Microbiology"
    ],
    [
      "heading",
      "Nasopharyngeal Carcinoma"
    ],
    [
      "heading",
      "Oncology"
    ],
    [
      "heading",
      "Organisms"
    ],
    [
      "heading",
      "Papillomaviruses"
    ],
    [
      "heading",
      "Pathogens"
    ],
    [
      "heading",
      "Pathology and Laboratory Medicine"
    ],
    [
      "heading",
      "Preventive Medicine"
    ],
    [
      "heading",
      "Prostate Cancer"
    ],
    [
      "heading",
      "Prostate Diseases"
    ],
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      "heading",
      "Public and Occupational Health"
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      "heading",
      "Research Article"
    ],
    [
      "heading",
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    ],
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      "heading",
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    ],
    [
      "heading",
      "Viral Pathogens"
    ],
    [
      "heading",
      "Viruses"
    ],
    [
      "plos",
      "/Biology and life sciences/Immunology/Vaccination and immunization"
    ],
    [
      "plos",
      "/Biology and life sciences/Microbiology/Medical microbiology/Microbial pathogens/Viral pathogens/Papillomaviruses/Human papillomavirus"
    ],
    [
      "plos",
      "/Biology and life sciences/Organisms/Viruses/DNA viruses/Papillomaviruses/Human papillomavirus"
    ],
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    ],
    [
      "plos",
      "/Medicine and health sciences/Diagnostic medicine/Cancer detection and diagnosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Immunology/Vaccination and immunization"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancer detection and diagnosis"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancer prevention/Cancer vaccines"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Carcinoma/Nasopharyngeal carcinoma"
    ],
    [
      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Genitourinary tract tumors/Prostate cancer"
    ],
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      "plos",
      "/Medicine and health sciences/Oncology/Cancers and neoplasms/Gynecological tumors/Cervical cancer"
    ],
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      "plos",
      "/Medicine and health sciences/Pathology and laboratory medicine/Pathogens/Microbial pathogens/Viral pathogens/Papillomaviruses/Human papillomavirus"
    ],
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      "plos",
      "/Medicine and health sciences/Public and occupational health/Preventive medicine/Vaccination and immunization"
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      "plos",
      "/Medicine and health sciences/Urology/Prostate diseases/Prostate cancer"
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  "pdf_url": "https://europepmc.org/articles/PMC13722152?pdf=render",
  "pmcid": "PMC13722152",
  "pmid": "42961926",
  "published": "2026-10-30",
  "publisher": "Public Library of Science",
  "ris": "https://research.draconitic.com/paper/fk5wvvq2zrmfe.ris",
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    {
      "first_seen": "2026-10-31T12:20:55Z",
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  "subjects": [
    {
      "field": "biology",
      "origin": "heading:Immunology",
      "subfield": "immunology"
    },
    {
      "field": "biology",
      "origin": "heading:Microbiology",
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      "field": "medicine",
      "origin": "plos:oncology",
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  "title": "Age-specific income losses due to HPV-attributable cancers in Singapore",
  "title_text": "Age-specific income losses due to HPV-attributable cancers in Singapore",
  "type": "peer-reviewed",
  "updated_at": "2026-11-03T12:22:43Z",
  "url": "https://research.draconitic.com/paper/fk5wvvq2zrmfe",
  "venue": "PLOS One",
  "versions": []
}