HealthDay News — Despite reductions in overall cancer mortality in the United States, the burden of some human papillomavirus- (HPV) associated cancers continues to rise with notable socioeconomic and racial/ethnic disparities, according to the annual Status of Cancer report.
From 2000 to 2009, incidence of HPV-associated cancer of the oropharynx rose among white men and women, as did the rate of anal cancer among whites and blacks of both sexes, and cancer of the vulva among white and black women, Ahmedi Jemal, DVM, PhD, of the American Cancer Society in Atlanta, and colleagues found.
In 2009, only about 32% of U.S. adolescent girls had received the full three-series dose necessary to confer protection against HPV — well below the the Healthy People 2020 target of 80% — the researchers noted.
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The “Annual Report to the Nation on the Status of Cancer, 1975–2009” appears in the Journal of the National Cancer Institute and is prepared through collaboration of the American Cancer Society, the CDC, the National Cancer Institute and the North American Association of Central Cancer Registries.
Jemal and colleagues examined the prevalence of HPV vaccination coverage from 2008 to 2010 and of Papanicolaou (Pap) testing during 2010. Long- and short-term incidence trends for HPV-associated cancers were examined. Overall, HPV-associated cancers accounted for 3.3% of all cancers among women in 2009 and 2% of those among men.
Although head and neck cancers, anal and cancers of the vulva increased from 2000 to 2009, cervical cancer incidence declined for women in all racial and ethnic groups, except American Indians and Alaskan natives.
Vaginal cancer rates decreased, but only among black women, whereas rates of penile cancer remained unchanged among men in all racial and ethnic groups.
Incidence rates for anal (2.6 per 100,000) and vulvar cancer (2.5 per 100,000) were highest among white women. Among men, blacks had the highest rate of anal cancer at 2.1 per 100,000.
Incidence rates for vaginal cancer were highest among black women at 0.8 per 100,000. Finally, incidence rates for cervical cancer were highest among Hispanic women, at 14.4 per 100,000, followed by blacks at 12.6 per 100,000.
HPV vaccination coverage was significantly lower than the national average in the uninsured and in some Southern states (14% and 20%, respectively, compared with 32%) — populations in whom cervical cancer rates were highest and prevalence of recent Pap testing lowest.
“Primary prevention of HPV-associated cervical, vaginal, vulvar, and anal cancers is achieved through childhood vaccination of girls and boys […] and strategies are needed to increase coverage among adolescents,” the researchers wrote.
Overall cancer mortality fell by 1.8% a year among men, 1.4% annually among women, and 1.8% a year among children under 14 from 2000 to 2009, study findings show.
In an accompanying editorial, Marc Brisson, PhD, of the Hôpital Saint-Sacrement in Québec city, and colleagues said the study results regarding HPV-associated cancer disparities among socioeconomic and racial groups were “strikingly different” compared with overall cancer trends.
“To fulfill the full potential of HPV vaccines, vaccination coverage must be high not only at the population-level but also within the populations with the greatest need,” they wrote.
