Guidelines on screening and vaccination against human papillomavirus (HPV) resulted in a decline in HPV-related cervical cancer. However, other viral cancers – for which there are no clear screening guidelines – are on the rise in both men and women, according to a population-based study.1,2
“In young women, cervical cancer is steadily decreasing with screening and possibly vaccination at the population level,” said senior author Cheng-I Liao, MD of Kaohsiung Veterans General Hospital in Kaohsiung, Taiwan, during a presentation of the data at a pre-press conference the 2021 annual meeting of the American Society of Clinical Oncology (ASCO).
HPV is associated with more than 90% of cervical and anal cancers and 60% to 75% of oropharyngeal, vulvar, vaginal, and penile tumors.3 The aim of the study was to assess trends in the incidence of HPV-associated cancers using the United States Cancer Statistics Database from 2001 to 2017.
Over the 17 year period there were 657,317 cancer cases, of which 393,298 (60%) occurred in women. The most common cancer in female patients was cervical cancer (52%). In men (n = 264,019), oropharyngeal squamous cell carcinoma (SCC; 80%) was the most common malignancy, which corresponds to a five-fold higher incidence compared to women.
During the study period, the incidence of cervical cancer decreased by 1.03% per year (P. P.
However, for other HPV-related cancers without standardized screening guidelines, the study period increased, with the incidence increasing in men by 2.71% per year and in women by 0.77%. Other HPV-associated cancers included anal and rectal SCC, oropharyngeal SCC, penile cancer, vulvar SCC, and vaginal SCC.
In women over 50 years of age, the annual percentage change in the incidence of anal and rectal SCC was 3.55% (P. P.
“The decrease in cervical cancer is welcome news and may reflect an intense effort to screen and vaccinate patients at risk,” said Dr. med. Lori J. Pierce, FASTRO, FASCO, in a press release. “This study clearly shows that we still have a lot of work to do to reverse the rising incidence rates of other HPV-related cancers.”
Investigators plan to gather information from other databases on the rate of HPV testing and vaccinations. Additional research will be needed to address a lack of screening and vaccination recommendations for HPV-associated cancers other than cervical cancer.
1. HPV-Associated Cancers in the US Over the Last 17 Years – Did Screening or Vaccination Make a Difference? Presented at: 2021 ASCO Annual Meeting Virtual Embargoed Presscast; May 19, 2021; Virtual.
2. With strict screening and vaccination guidelines, cervical cancer rates decrease. Other HPV-related cancers are on the rise. Press release. American Society for Clinical Oncology. May 19, 2021. Accessed May 19, 2021. https://bit.ly/3ylfjJ1
3. Saraiya M., Unger ER, Thompson TD, et al. US Assessment of HPV Types in Cancer: Impact on Current and 9-valent HPV Vaccines. J Natl Cancer Inst. 2015; 107 (6): djv086. doi: 10.1093 / jnci / djv086