Issue: August 2016
August 17, 2016
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CDC: Number of HPV-associated cancers rises

Issue: August 2016
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Approximately 39,000 new cases of HPV–associated cancers were diagnosed per year in the United States between 2008 and 2012, according to data from the CDC’s MMWR.

Perspective from Electra D. Paskett, PhD

Nearly 29,000 cases of HPV-associated cancers could be prevented through HPV vaccination, according to the researchers.

“Although most HPV infections are asymptomatic and clear spontaneously, persistent infections with one of 13 oncogenic HPV types can progress to precancer or cancer,” Laura J. Viens, MD, of the Division of Cancer Prevention and Control at the CDC, and colleagues wrote.

Vaccination is available for HPV-16 and HPV-18, which cause 63% of HPV-associated cancers. There are also vaccinations for HPV-31, HPV-33, HPV-45, HPV-52 and HPV-58, which contribute to an additional 10% of cancers.

A total of 38,793 HPV-associated cancers occurred annually between 2008 and 2012.

Fifty-nine percent (n = 23,000) of HPV–associated cancers occurred in women during this time, and 41% (n = 15,793) occurred in men. The overall annual incidence was 11.7 cases per 100,000 persons.

These data represent an increase from the preceding 5-year period (2004-2008), during which 33,369 HPV-associated cancers were diagnosed.

The most common HPV–associated cancers included cervical carcinomas (n = 11,771) and oropharyngeal squamous cell carcinomas (n = 15,738).

A higher number of men were diagnosed with oropharyngeal cancer (7.6 vs. 1.7 per 100,000 persons), whereas women appeared more likely to be diagnosed with anal cancer (1.8 vs. 1.1) or rectal cancer (0.3 vs. 0.2).

Cervical cancer incidence was higher among blacks than whites (9.2 vs. 7.1), and among Hispanics than non-Hispanics (9.7 vs. 7.1).

Vulvar carcinoma had a higher incidence in whites (2.1) than blacks (1.5) or Hispanics (1.3).

Black women had a lower rate of anal carcinoma than white women (1.4 vs. 1.9), whereas the incidence was higher among black men than white men (1.5 vs. 1.1).

Oropharyngeal cancer occurred more frequently in whites (men, 8; women, 1.8) than in blacks (men, 6.9; women, 1.5) and Hispanics (men, 4.2; women, 0.9).

Utah had the lowest rate of HPV-associated cancers, with 7.5 cases per 100,000 persons. Kentucky had the highest incidence, with 14.7 cases per 100,000 persons.

Utah remained the state with the lowest HPV-associated cancer rate among men (6 per 100,000) and women (9.1 per 100,000). The highest incidence rates for women occurred in Kentucky and West Virginia (17 per 100,000), whereas the highest rates for men were seen in Washington, D.C. (12.8 per 100,000).

The U.S. Census Southern region had the highest HPV-associated cancer rates by geographic region (11.7 per 100,000). The highest cervical cancer rates were observed in Puerto Rico (11.7 per 100,000).

“Of the 38,793 cancers that occurred each year in the United States at anatomic sites associated with HPV, approximately 30,700 can be attributed to HPV,” Viens and colleagues wrote. “Of these, 24,600 cancers are attributable to HPV types 16 and 18, which are included in all current HPV vaccines, and 28,500 are attributable to high-risk HPV types included in the 9-valent HPV vaccine. Ongoing surveillance for HPV-associated cancers using high-quality population-based registries is needed to monitor trends in cancer incidence that might result from increasing use of HPV vaccines and changes in cervical cancer screening practices.” – by Cameron Kelsall

Disclosure: The researchers report no relevant financial disclosures.