PerspectiveIn the Journals

CDC: Number of HPV–associated cancers on the rise

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July 8, 2016

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 Morbidity and Mortality Weekly Report.

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

“HPV is a known cause of cervical cancers, as well as some vulvar, vaginal, penile, oropharyngeal, anal and rectal cancers,” Laura J. Viens, MD, of the division of cancer prevention and control at the CDC, and colleagues wrote. “Although most HPV infections are asymptomatic and clear spontaneously, persistent infections with one of 13 oncogenic HPV types can progress to precancer or cancer.”

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.

Of the total annual number of HPV–associated cancers diagnosed, 30,700 could be attributed to HPV infection (women, n = 19,200; men, n = 11,600).

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 black individuals than white individuals (9.2 vs. 7.1), and among Hispanic individuals than non-Hispanic individuals (9.7 vs. 7.1).

Vulvar carcinoma had a higher incidence in white individuals (2.1) than black individuals (1.5) or Hispanic individuals (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 white individuals (men, 8; women, 1.8) than in black individuals (men, 6.9; women, 1.5) and Hispanic individuals (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 type 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.

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PERSPECTIVE
Electra D. Paskett

Electra D. Paskett

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents an STD to a vaccine that prevents cancer.

This is better than a cancer cure — it’s cancer prevention. But in the United States, only 40% of girls and 20% of boys are completing the vaccinations. It is extremely sad.

Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes — and we would have dramatic decrease in HPV–related cancers across the globe.


Electra D. Paskett, PhD
The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital

Disclosure: Paskett reports no relevant financial disclosures.