HPV-caused cancer incidence and trends

The following table summarizes current estimates of the number of new HPV-caused cancer cases occurring in 2008 by anatomic site:

Site# in less developed regions# in more developed regions# in United States
Cervix uteri450,00077,00011,500
Oropharynx 6,400 15,000 7,400
Anus 12,000 12,000 4,500
Vulva 4,100 7,500 1,600
Vagina 5,700 3,400 500
Penis 7,600 3,200 400

(Data from Table 4 in "Global burden of human papillomavirus and related diseases" and Table 2 in MMWR / April 20, 2012 / Vol. 61 / No. 15.)

Thus cervical cancer represents about 92% of HPV-caused cancer in less developed countries, about 65% in more developed countries, and about 55% in the United States.

Presumably the reason cervical cancer represents a lower percentage of HPV-caused cancers in the US is that we have a relatively successful cervical cancer screening program compared to less well developed countries, and that there is as yet no screening program for non-cervical HPV-caused cancers.

Trends in HPV-caused cancer incidence

"Cervical cancer trends in the United States: a 35-year population-based analysis" says
"The incidence rates for squamous carcinoma decreased by 61.1% from 10.2/100,000 (1973-1975) to 3.97/100,000 (2006-2007).
Incidence rates for adenosquamous cell carcinomas decreased by 16% from 0.27/100,000 (1973-1975) to 0.23/100,000 (2006-2007), and
incidence rates for adenocarcinomas increased by 32.2% from 1.09/100,000 (1973-1975) to 1.44/100,000 (2006-2007).
This increase in adenocarcinomas was due to an increase in incidence in white women; a decrease in incidence was observed for black women.
CONCLUSIONS: Although marked reductions in the overall and race-specific incidence rates of invasive cervical cancer have been achieved, they mask important variation by histologic subtype. These findings suggest that alternatives to Pap smear-based screening, such as human papillomavirus (HPV) testing and HPV vaccination, need to be prioritized if adenocarcinomas of the cervix are to be controlled."
"Examining the incidence of human papillomavirus-associated head and neck cancers by race and ethnicity in the U.S., 1995-2005" says
for HPV-associated sites, HNC incidence for Non-Hispanic White males aged 45-54 increased at the greatest rate, with an APC of 6.28% (p<0.05)
"Human papillomavirus and rising oropharyngeal cancer incidence in the United States" says
If recent incidence trends continue, the annual number of HPV-positive oropharyngeal cancers is expected to surpass the annual number of cervical cancers by the year 2020.

Copyright 2011, 2012, 2013 Dan Kegel
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