Trends in Human Papillomavirus-Associated Cancers - United States, 1999-2015

Abstract

Human papillomavirus (HPV) is a known cause of cervical cancer, as well as some oropharyngeal, vulvar, vaginal, penile, and anal cancers. To assess trends, characterized by average annual percent change (AAPC), in HPV-associated cancer incidence during 1999-2015, CDC analyzed data from cancer registries covering 97.8% of the U.S.

Population: A total of 30,115 new cases of HPV-associated cancers were reported in 1999 and 43,371 in 2015. During 1999-2015, cervical cancer rates decreased 1.6% per year; vaginal squamous cell carcinoma (SCC) rates decreased 0.6% per year; oropharyngeal SCC rates increased among both men (2.7%) and women (0.8%); anal SCC rates also increased among both men (2.1%) and women (2.9%); vulvar SCC rates increased (1.3%); and penile SCC rates remained stable. In 2015 oropharyngeal SCC (15,479 cases among men and 3,438 among women) was the most common HPV-associated cancer. Continued surveillance through high-quality cancer registries is important to monitor cancer incidence and trends in these potentially preventable cancers.

FIGURE 1

Trends in age-adjusted incidence of cervical carcinoma among females and oropharyngeal SCC among men, — United States, 1999–2015 Sources: CDC's National Program of Cancer Registries; National Cancer Institute's Surveillance, Epidemiology, and End Results program. Abbreviations: AAPC=average annual percent change; NS=not significant; SCC = squamous cell carcinoma. * Trends were measured with AAPC in age-adjusted rates, and were considered to increase or decrease if p<0.05; otherwise trends were considered stable. ^† HPV-associated cancers were defined as cancers at specific anatomic sites with specific cell types in which HPV DNA frequently is found. All cancers were microscopically confirmed. Cervical cancers (International Classification of Diseases for Oncology, Third Edition [ICD-O-3] site codes C53.0–C53.9) are limited to carcinomas (ICD-O-3 histology codes 8010–8671, 8940–8941). Oropharyngeal (ICD-O-3 site codes C01.9, C02.4, C02.8, C05.1, C05.2, C09.0, C09.1, C09.8, C09.9, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C14.0, C14.2 and C14.8) cancer sites are limited to squamous cell carcinomas (ICD-O-3 histology codes 8050–8084, 8120–8131). ^§ Cancer incidence compiled from cancer registries that meet the data quality criteria for all invasive cancer sites combined for each year during the period 1999–2015 (covering 97.8% of the U.S. population).

FIGURE 2

Trends in age-adjusted HPV-associated cancer incidence, by cancer type and sex — United States, 1999–2015 Sources: CDC's National Program of Cancer Registries; National Cancer Institute's Surveillance, Epidemiology, and End Results program. Abbreviations: AAPC=average annual percent change; HPV = human papillomavirus; NS=not significant; SCC = squamous cell carcinoma. * Trends were measured with AAPC in age-adjusted rates, and were considered to increase or decrease if p<0.05; otherwise trends were considered stable. ^† HPV-associated cancers were defined as cancers at specific anatomic sites with specific cell types in which HPV DNA frequently is found. All cancers were microscopically confirmed. Vaginal (International Classification of Diseases for Oncology, Third Edition [ICD-O-3] site code C52.9), vulvar (ICD-O-3 site codes C51.0–C51.9), penile (ICD-O-3 site codes C60.0–60.9), anal (including rectal SCC; ICD-O-3 site code C20.9, C21.0–C21.9), and oropharyngeal (ICD-O-3 site codes C01.9, C02.4, C02.8, C05.1, C05.2, C09.0, C09.1, C09.8, C09.9, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C14.0, C14.2 and C14.8) cancer sites are limited to squamous cell carcinomas (ICD-O-3 histology codes 8050–8084, 8120–8131). ^§ Cancer incidence compiled from cancer registries that meet the data quality criteria for all invasive cancer sites combined for each year during the period 1999–2015 (covering 97.8% of the U.S. population).