‘Great Deal of Work’ Still Needed to Reverse Increasing Rates of Several HPV-Related Cancers

Almost 20 years of data indicate that the incidence of HPV-related cervical cancer is noticeably declining, however other cancers related to the virus continue, and are expected, to increase.

There has been a notable decline in the incidence of HPV-related cervical carcinoma over a nearly two-decade timeframe, possibly as a result of clear guidance regarding screening measures and HPV vaccination for vulnerable patient groups, according to data from a population-based study.

However, the study results also indicated that the incidence of other HPV-related cancers without clear screening guidelines are on the rise in both men and women.

“In young women, cervical carcinoma is decreasing consistently with screening, and possibly vaccination, at the population level,” lead author Dr. Cheng-I Liao, of Kaohsiung Veterans General Hospital in Kaohsiung, Taiwan, said during a presentation of the data during a news briefing leading up to the American Society of Clinical Oncology (ASCO) 2021 Annual Meeting.

Previous research has shown that HPV is associated with more than 90% of cervical and anal cancers and 60% to 75% of oropharyngeal, vulvar, vaginal and penile tumors.The purpose of this study was to assess trends in the incidence of HPV-associated cancer using the United States Cancer Statistics Database from 2001 to 2017.

In the 17-year timeframe, there were 657,317 cases of cancer, 393,298 (60%) of which were in women. The most commonly occurring cancer in female patients was cervical carcinoma (52%). Among the 264,019 men, the most common malignancy was oropharyngeal squamous cell carcinoma (SCC; 80%), which represents a 5-fold higher incidence compared with women.

Over the study period, cervical cancer incidence decreased by 1.03% per year, but this rate was significantly higher in patients aged 20 to 24 years who saw a much greater decrease in disease incidence, at 4.63% per year. Similar effects were seen in women over the age of 65, who saw a greater than 2% incidence decline over the study period. The study authors noted that this is likely due to the effects of HPV vaccination and screening.

However, other HPV-related cancers without standardized screening guidelines saw increases over the study period, with a 2.71% incidence rise per year in men and a 0.77% increase in women. Other HPV-associated cancers included anal and rectal SCC, oropharyngeal SCC, penile cancer, vulvar SCC and vaginal SCC.

In women over the age of 50, the annual percentage change in the incidence of anal and rectal SCC was 3.55%. When compared with the 1.53% decline in the incidence of cervical cancer in the same patient population, trends suggest that HPV-related anal and rectal SCC will surpass its incidence in the coming decade, and likely in the next five years.

“The decrease in cervical cancer is welcome news and may reflect intensive efforts to screen and vaccinate patients at risk,” ASCO President Dr. Lori J. Pierce, said in a news release. “Clearly, this study shows that we still have a great deal of work to do in order to reverse the increasing incidence rates of other HPV-related cancers.”

The authors noted that they plan to gather more information from other databases about the rate of HPV testing and vaccination. Additional research will be necessary to tackle a lack of disease screening and vaccination recommendations for HPV-associated cancers other than cervical.

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