Age, race linked to survival disparities for HPV-associated cancers
The relative survival rate for an individual with HPV-associated cancer appeared largely dependent on demographic characteristics such as sex, race and age, according to a population-based study.
White patients demonstrated higher 5-year survival than black patients for all HPV-related cancers and all age groups, suggesting large disparities exist, the research showed.
“This new study shows that race, sex and age can make a difference in surviving HPV-associated cancers,” Mona Saraiya, MD, MPH, associate director in the division of cancer prevention and control’s office of international cancer control at the CDC, said in a press release.
More than 38,000 cases of HPV-related cancers are diagnosed annually in the United States.
Almost all cervical cancers are associated with HPV infection, and cervical and oropharyngeal cancers account for more than 50% of all HPV-associated cancers. However, most studies have focused on incidence, and not survival, of HPV-associated cancers. Survival reports on less common HPV-associated cancers — such as vaginal, vulvar, penile, anal and rectal — also are lacking.
Researchers sought to determine how survival rates varied by demographics — such as race and age — among each of the different HPV-related cancers.
Saraiya and colleagues used 27 population-based cancer registries to evaluate survival data from 220,211 patients (83% white; 32.7% women) diagnosed with HPV-related cancer between 2001 and 2011. Analyses included only invasive cancer cases that met specified histologic criteria for HPV-associated cancers.
The researchers measured 5-year survival — by age, race and sex — from diagnosis until death.
The majority of patients had oropharyngeal squamous cell carcinomas (36.4%) and cervical carcinomas (36.1%).
The 5-year age-standardized relative survival appeared highest among vulvar (66%) and anal squamous cell carcinoma (65.9%), and lowest among penile (47.4%) and oropharyngeal squamous cell carcinoma (51.2%).
The 5-year age-standardized relative survival decreased with increasing age for a majority of HPV-associated cancers. However, researchers observed a slight increase in survival for patients aged 40 to 49 years compared with those aged younger than 40 years diagnosed with vaginal (66.6% vs. 62.7%), vulvar (85.9% vs. 84.5%) and anal squamous cell carcinoma (72.6% vs. 66.1%).
White patients comprised more than 85% of the HPV-associated cancer types except for cervical carcinoma (77.2%) and vaginal squamous cell carcinoma (80.9%).
Researchers reported higher 5-year age-standardized relative survival among white than black patients for all HPV-associated cancers across all age groups — 64.8% vs. 57% for cervical carcinoma; 48.4% vs. 34.7% for penile squamous cell carcinoma; 69.3% vs. 59.8% for anal squamous cell carcinoma; 61.2% vs. 45.5% for rectal squamous cell carcinoma; and 53.5% vs. 32.4% for oropharyngeal squamous cell carcinoma.
Researchers observed the greatest survival differences between white and black patients for oropharyngeal squamous cell carcinoma — including for those age younger than 40 years (76% vs. 51.7%), 40 to 49 years (73.2% vs. 40%), 50 to 59 years (67.6% vs. 38.6%) — and patients aged 40 to 49 years with penile squamous cell carcinoma (58.5% vs. 34.5%).
Women showed higher 5-year relative survival rates than men for anal squamous cell carcinoma (69.3% vs. 59.8%), and rectal squamous cell carcinoma (61.2% vs. 45.5%), but slightly decreased survival for oropharyngeal squamous cell carcinoma (49.8% vs. 51.7%).
Individuals can avoid an HPV-related cancer by receiving the HPV vaccination and undergoing screening for cervical cancer at the recommended ages.
Patients who have been diagnosed with an HPV-associated cancer should work with their health care provider to create a personalized plan for care, Saraiya said in the release.
“Health care providers can take steps to assure that they are offering the recommended screening and treatment, regardless of a patient’s race, age or sex,” Saraiya said. – by Melinda Stevens
Disclosures: The authors report no relevant financial disclosures.