Quality of life in women with a human papillomavirus-positive screening test, cervical neoplasia, or cervical cancer in Latin America

Purpose: Human papillomavirus (HPV) infection and HPV-associated diseases impact health-related quality of life (HRQOL). We aimed to measure HRQOL in women with HPV-positive test results, cervical intraepithelial neoplasia (CIN), or cervical cancer in Latin America. Methods: We enrolled women aged 18 to 75 years from Bolivia, Colombia, Honduras, Peru, and Uruguay. We used the EQ-5D-5L instrument to calculate EQ-5D index scores with country-specific sets of health preferences when available. We calculated medians and interquartile ranges (IQR) of EQ-5D index and conducted an exploratory analysis comparing HRQOL loss by diagnosis and country with a gamma regression. Results: We present results from 1,073 participants. Median age was 43 years (IQR: 34-52). The EQ-5D index scores by diagnosis were as follows: HPV-positive test alone 0.906 (standard deviation [SD]: 0.129), CIN1: 0.891 (SD: 0.136), CIN2: 0.892 (SE: 0.124), CIN3: 0.870 (SD: 0.138), and cervical cancer: 0.737 (SD: 0.268). HRQOL was associated with age, diagnosis, and country; there was a significant decreasing trend in HRQOL with worsening health state. Women with cervical cancer had a 3.19-fold higher HRQOL loss than women with an HPV-positive test alone or CIN1. We also found significant differences in HRQOL loss across countries, after adjustment for diagnosis and sociodemographic factors. Conclusion: HRQOL decreased with diagnosis severity, with significant differences between countries. To conduct cost-effectiveness modeling on HPV preventive interventions, obtaining accurate HRQOL estimates is essential. This process should consider the diverse local health preferences influenced by sociodemographic and cultural factors, as well as the population's beliefs and experiences regarding health.