Reduction of HPV-related cervical cancer may help in screening and vaccination guidance for other types of tumors

Evidence from a population-based study of the incidence of human papillomavirus (HPV) -related cancers shows a significant reduction in cervical cancer. This may be due to screening measures for vulnerable patient groups and clear guidance on HPV vaccination.^1,2

On the other hand, the incidence of other HPV-related cancers without clear screening guidelines is increasing in both men and women.

“In young women, cervical cancer has consistently decreased with population-level screening and perhaps vaccination,” said Cheng-I, lead author of the Kaohsiung Veterans General Hospital in Kaohsiung, Taiwan. Liao and MD are media briefings leading up to the 2021 Annual Meeting of the American Society of Clinical Oncology (ASCO).

HPV is associated with over 90% of cervical and anal cancers and 60% to 75% of tumors of the oropharyngeal, vulva, vagina, and penis.³ The purpose of this study was to assess trends in the incidence of HPV-related cancers using the US Cancer Statistics Database from 2001 to 2017.

Over the 17 years, 657,317 cancers have occurred, of which 393,298 (60%) are women. The most common cancer in female patients was cervical cancer (52%). In men (n = 264,019), the most common malignancy is oropharyngeal squamous cell carcinoma (SCC; 80%), which has a five-fold higher incidence than women.

During the study period, the incidence of cervical cancer decreased by 1.03% annually (P <.05) However, this rate was 4.63% per year, which was significantly higher in patients aged 20 to 24 years who saw a much greater reduction in incidence. A similar effect was seen in women age 65 and older, with an incidence reduction of more than 2% during the study period (P <.05). Researchers said this was likely due to the effects of HPV vaccination and screening.

However, other HPV-related cancers without standardized screening guidelines increased during the study period, with an annual increase in incidence of 2.71% in men and 0.77% in women. Other HPV-related cancers include anal and rectal SCC, mesopharyngeal SCC, penile cancer, vulvar cancer, and vaginal squamous cell carcinoma.

For women over the age of 50, the annual rate of change in the incidence of SCC in the anus and rectum was 3.55% (P <.001). Compared to a 1.53% reduction in the incidence of cervical cancer in the same patient population (P <.001), trends suggest that HPV-related anal and rectal SCCs will exceed their incidence over the next 10 years, and perhaps the next 5 years.

“The reduction in cervical cancer is welcome news and may reflect an intensive effort to screen and vaccinate at-risk patients,” said ASCO’s Lori J. Pierce. Doctor of Medicine, FASTRO, FASCO said in a press release. “Clearly, this study shows that we still have a lot to do to reverse the increased incidence of other HPV-related cancers.”

Researchers plan to collect information on HPV testing and vaccination rates from other databases. Additional research will be needed to address the lack of disease screening and vaccination recommendations for HPV-related cancers other than cervical cancer.

References

1. HPV-related cancers in the United States over the last 17 years – has screening or vaccination made any difference? Announcement location: 2021 ASCO Annual Meeting Virtual Embargoed Presscast; May 19, 2021; Virtual.

2. Strong screening and vaccination guidelines reduce the incidence of cervical cancer. Other HPV-related cancers are on the rise. news release. American Society of Clinical Oncology. May 19, 2021. Accessed on May 19, 2021. https: //bit.ly/3ylfjJ1

3. Saraiya M, Unger ER, Thompson TD, etc. US Assessment of HPV Type in Cancer: Current and Impact on 9-valent HPV Vaccines. J Natl Cancer Inst.. 2015; 107 (6): djv086 Doi: 10.1093 / jnci / djv086