Cervical cancer rates are falling, but other HPV cancers are rising

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Cervical cancer the incidence in the United States decreased by approximately 1% annually from 2001 to 2017, but at the same time increased the incidence of other human papilloma virus (HPV) related to cancers, reveals a new study.

During the same period, there was an annual increase of 1.3% per year in oropharyngeal, anal, rectal and vulvar cancers in women and 2.3% per year in these cancers in men.

Researchers point out that HPV is associated with more than 90% of cervical cancers and between 60% and 75% of oropharyngeal, vulvar, vaginal and penis cancers in the US.

The incidence of oropharyngeal cancer increased by 2.3% overall, with 2.7% in men and 0.77% in women. The study found that the incidence of this cancer was almost five times higher in men: 8.89 per 100,000 population compared to 1.68 per 100,000 population for women.

In addition, among women over 50, anal and rectal cancer the incidence increased by 3.5% annually; at the same time, the incidence of cervical cancer decreased by 1.5% annually.

The incidence of oropharyngeal cancer and anal and rectal cancer is expected to continue, according to the authors.

The data showing these new trends come from an analysis of 657,317 individuals obtained from the United States Cancer Statistics program, conducted by Cheng-I Liao, MD, from Kaohsiung Veterans Hospital, Taiwan, and colleagues.

The study was highlighted at a press conference prior to the annual meeting of the American Society of Clinical Oncology (ASCO), where the study will be presented on June 6th.

These incidence trends may reflect the availability of clear guidelines for screening and vaccination for the prevention of HPV-related cervical cancer, and the lack of guidelines and standardized screening and vaccination for other cancers related to HPV, according to the authors.

The team also found that cervical cancer accounted for 52% of all HPV-related cancers during the study period. The decrease in the incidence of cervical cancer over time was greater among women aged 20 to 24 years (4.6% per year), compared with those aged 25 to 29 years (1.6%) and 30 -34 years (1.1%),

Liao speculated that this age-based difference suggests a potential effect of HPV vaccination, greater acceptance of the vaccine among younger women, and clear guidelines for screening and vaccination.

However, an expert who went to comment was not so sure. Too soon, too much credit will be given to HPV vaccination for lower rates of cervical cancer, he said. Jennifer Young Pierce, MD, MPH, gynecologic oncologist at Mitchell Cancer Institute, University of South Alabama, Mobile.

The continued rise in non-HPV-related cancers other than cervical cancer supports the point that screening, rather than vaccination, accounts for much of the decline seen in the incidence of cervical cancer, Pierce said. Medscape Medical News.

Vaccination in men lags behind that of women and there is a lack of good methods for detecting head and neck cancers, he explained.

“When we have both vaccination and screening in these other cancers at high rates, we will also see significant decreases in these cancers,” he said.

“I’m very excited about the data, but I don’t think it’s related to vaccination as a method of prevention,” said Pierce, a professor of interdisciplinary clinical oncology who has been involved in numerous studies and initiatives related to HPV vaccine uptake. of vaccines since its approval in 2006.

HPV vaccination

The HPV vaccine was first approved to prevent HPV-related cervical cancer in 2006, with an indication for girls and women ages 9 to 26. The vaccine indication was expanded in 2011 to include boys ages 11 to 12 and is now approved for children under 45.

However, neither standardized screening nor HPV vaccination is currently recommended for any HPV-related cancer other than cervical cancer, Liao said.

Vaccination for much of the current study period (2001-2017) did not apply to most people with cancer, Pierce said in an interview, noting that vaccinated individuals “do not yet have the vaccine. ‘old enough to be part of the group let’s talk about it’.

Rather, the increased use of HPV screening along with Pap smears for cervical cancer was becoming widespread at the time and probably took on more precancerous lesions and therefore helped decrease the incidence of cervical cancer in women in their 40s, 50s, 60s, and 70s, she said.

However, Pierce credits the movement of vaccines to raising awareness of the risk of HPV.

“He has done a great job educating the population about the dangers of these cancers … and that there is more we can do to prevent them,” he said.

Like Liao, he stressed the need for research focused on finding more effective detection modalities and vaccine efficacy.

He also commented on the study, president of ASCO Lori J. Pierce, MD, a radiation oncologist, professor and vice president of academic and teaching matters at the University of Michigan, Ann Arbor, said the findings underscore the need for ongoing exploration of possible strategies such as HPV detection for populations of other risk.

“We can select higher-risk populations, so it would make sense to make a screen,” he said.

“Clearly, this study shows that we still have a lot of work to do to reverse the rising incidence rates of other HPV-related cancers,” he added in a press release.

In a pre-press conference interview, Pierce said Medscape Medical News that the findings are important because the result “opens all our eyes to the trends of HPV – related cancers in the US.

“This is something that has not been studied well over time,” he added, noting that if there are guidelines for HPV-related cancers other than cervical cancer, they are inconsistent.

In addition, the vaccine may “cover a significant portion of the etiological viruses that cause these cancers,” thus helping to prevent other HPV-related cancers, he said.

For this reason, additional research and strategies are needed to overcome vaccine vaccination, increase overall vaccination rates, and develop consistent guidelines.

“I think there needs to be more resources and research to address the lack of detection of these other HPV-related cancers and we need to have consistent vaccination guidelines, because these cancers can be prevented.”

Liao and Pierce have not revealed any relevant financial relationship.

Annual Meeting of the American Society of Clinical Oncology: Summary 107. It will be presented on June 6, 2021.

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