ASCO Annual Meeting

ASCO Annual Meeting

Perspective from Marcia Amelia Ciccone, MD
Source:

Liao C-I, et al. Scheduled for presentation at: ASCO Annual Meeting (virtual meeting); June 4-8, 2021.



Disclosures: Liao reports no relevant financial disclosures. Please see the abstract for all researchers’ relevant financial disclosures.
May 21, 2021
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Cervical cancer incidence declines as rates of other HPV-associated cancers rise

Perspective from Marcia Amelia Ciccone, MD
Source:

Liao C-I, et al. Scheduled for presentation at: ASCO Annual Meeting (virtual meeting); June 4-8, 2021.



Disclosures: Liao reports no relevant financial disclosures. Please see the abstract for all researchers’ relevant financial disclosures.
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Incidence of cervical cancer declined as rates of other HPV-associated cancers increased significantly in the U.S. from 2001 to 2017, according to a population-based study of trends presented during the virtual ASCO Annual Meeting.

“As a gynecologic oncologist, I knew about cervical, vulvar and vaginal cancer, but HPV can induce a lot of cancers, such as oropharyngeal, penile, anal and rectal cancers,” Cheng-I Liao, MD, attending physician at Kaohsiung Veterans General Hospital in Kaohsiung, Taiwan, told Healio. “If we can figure out the status of HPV-associated cancer in the United States, we can understand the need of our patients and try to eliminate these diseases. The U.S. Cancer Statistics Public Use Databases had near-100% population of the U.S. We can use this to solve these problems.”

Incidence of cervical cancer declined as rates of other HPV-associated cancers increased significantly in the U.S. from 2001 to 2017.
Data were derived from Liao C-I, et al. Presented at: ASCO Annual Meeting (virtual meeting); June 4-8, 2021.

Liao and colleagues analyzed incidence and trends of HPV-associated cancers among 657,317 individuals (60% women) included in U.S. Cancer Statistics databases between 2001 and 2017, and sought to determine if screening or vaccinations had made a difference during that period. They stratified cancers by sex, race and age groups and calculated incidence trends per 100,000 using SEER*Stat and Joinpoint Trend Analysis software.

Results showed incidence of cervical carcinoma — which accounted for 52% of all HPV-associated cancers in women and for which, researchers noted, clear guidelines on screening and vaccination exist — decreased by about 1% annually (annual percent change [APC] = 1.03%; P < .05) between 2001 and 2017, to 7.12 cases per 100,000 in 2017.

Meanwhile, rates of HPV-related cancers without standardized screening guidelines increased among women, including oropharyngeal (APC = 0.77%), anal and rectal (APC = 2.75%), and vulvar (APC = 1.27%) cancers (P < .001 for all).

Cheng-I Liao, MD
Cheng-I Liao

“It is likely that the significant decrease in cervical cancer incidence resulted from clear guidelines for cervical cancer screening and may also reflect promotion and acceptance of vaccination, particularly in younger women,” Liao said.

Researchers observed the sharpest decrease in cervical cancer incidence among women aged 20 to 24 years (APC = 4.63%; P < .001).

Among women aged older than 50 years, incidence of cervical cancer decreased by 1.53% per year, whereas incidence of anal and rectal cancer increased by 3.55% per year. Researchers projected that by 2025, rates of anal and rectal cancer would surpass those of cervical carcinoma among women in every age group over 50 years.

Among men, researchers reported an annual increase in HPV-associated cancers of 2.36% per year (P < .001), with a rate of 11 per 100,000 in 2017. Cancers with the highest increases among men included oropharyngeal (APC = 2.71%) and anal and rectal squamous cell carcinoma (APC = 1.71%). Oropharyngeal squamous cell carcinoma accounted for over 80% of HPV-associated cancers in men, a fivefold higher incidence compared with women (age-adjusted incidence per 100,000, 8.89 vs. 1.68).

The HPV vaccine received approval in 2006 for girls and women aged 9 to 26 years to prevent HPV infection and the development of cervical cancer lesions. Updated recommendations in 2011 extended vaccination to boys aged 11 to 12 years. Vaccination currently is recommended for individuals up to age 45 years.

Liao and colleagues called for more resources and research to address the lack of screening and vaccination recommendations in the other preventable HPV-related cancers.

“In order to reduce these trends and achieve success comparable to what we’re seeing with cervical cancer, we must develop effective screening strategies and determine vaccine efficacy in these patient populations,” Liao said.