The incidence of cancers associated with human papillomavirus (HPV) infection increased by 17% from 2008 through 2012, as HPV vaccination uptake remained low, according to the CDC.
The annual incidence of HPV-associated cancers reached 39,000, including 30,700 directly attributable to the virus. The remaining cancers were associated with HPV by virtue of localization in anatomic areas where HPV DNA is often found. Women accounted for 59% of the total case burden, CDC investigators reported in Morbidity and Mortality Weekly Report.
Oropharyngeal cancer constituted the largest share of HPV-related cancers (15,738 of the total), followed by cervical cancer (11,771). Anal (5,000) and vulvar (3,500) cancers accounted for most of the remaining cases. More than 90% of cervical cancers and 70% of oropharyngeal cancers were attributable to HPV.
Of the cancers directly attributable to HPV, more than 90% could have been prevented by currently available vaccines, researchers estimated. The data showed that 80% of the cancers were caused by HPV16 and HPV18, which are covered by all commercially available vaccines. An additional 12% were caused by HPV types 31, 33, 45, 52, and 58, all of which are covered by the newer nine-valent vaccine.
Since 2006 the CDC has recommended HPV vaccination for girls and boys at age 11 or 12. The latest data from the agency showed that 60% of girls 13 to 17 had received at least one dose of an HPV vaccine, and 40% had received the recommended three doses. Among boys the same age, 41.7% had received at least one dose, and 21.6% had received all three.
The CDC data leave little doubt that “this is an emerging epidemic that we are just seeing the start of,” said Theodoros Teknos, MD, a head and neck cancer specialist at Ohio State University Comprehensive Cancer Center in Columbus. “This is true for all HPV-related cancers, but particularly for raising awareness about the non-cervical cancers. The data show just how rapidly this is accelerating.”
HPV-related cancer of the oropharynx has increased by 300% since the 1980s, whereas throat cancers related to smoking have actually declined, he added.
Acknowledging that uptake of HPV vaccine remains suboptimal, Teknos pointed out that the vaccination rate has increased in recent years. A key to better adherence to the CDC recommendation for HPV vaccination is to emphasize cancer prevention, not prevention of an STD.
“If the data are ‘packaged’ to tell parents that they can prevent cancers in their sons and daughters by vaccinating them against HPV, there isn’t a mother or father alive who wouldn’t vaccinate their children,” he said.
Morbidity and Mortality Weekly Report (MMWR)Source Reference: Viens LJ, et al "Human papillomavirus-associated cancers -- United States, 2008-2012" Morb Mort Wkly Rep 2008; 65:661-666.