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CDC Releases First Estimate of Human Papillomavirus-Associated Cancer Data

About 25,000 cases occurred annually during 1998-2003

Twenty-five thousand cases of human papillomavirus (HPV)-associated cancers occurred in 38 states and the District of Columbia annually during 1998-2003, according to studies conducted by CDC. The report, "Assessing the Burden of Human Papillomavirus (HPV)-Associated Cancers in the United States (ABHACUS)," was published online and appears in the Nov. 15, 2008, supplement edition of Cancer.

"These estimates of HPV-associated cancers were collected prior to the development of the HPV vaccine. This gives us baseline data to measure the impact of HPV vaccine and cervical cancer screening programs in reducing the incidence of cervical cancer and other HPV-associated cancers and precancers," said Mona Saraiya, M.D., M.P.H., medical officer in CDC's Division of Cancer Prevention and Control and coordinator of the studies.

This first analysis of the largest, most comprehensive assessment of HPV-associated cancer data to date in the United States used cancer registry data from CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results Program. 

The top HPV-associated cancer sites were cervix, oral cavity and oropharynx, anus, vulva, penis, and vagina. HPV is the name of a group of viruses that includes more than 100 different types. More than 30 of these HPV types can be sexually transmitted.  Most people with HPV infection do not develop symptoms or health problems. Some HPV types can cause cervical cancer and other less common cancers, such as cancer of the vulva, vagina, anus, and penis. Other HPV types can cause genital warts.

Significant findings include:

Age-adjusted rates are presented in parentheses where appropriate and are per 100,000 persons.

• CERVIX:  More HPV-associated cancers occur in the cervix than any other site – about 10,800 per year. The incidence rate of cervical cancer was 8.9 women during 1998-2003.  Black and Hispanic women had higher rates of cervical cancer (12.6 and 14.2, respectively) than white and non-Hispanic women (both 8.4). 
• ORAL CAVITY AND OROPHARYNX: Cancers in some areas of the head and neck (oral cavity and oropharynx) are more likely to be HPV-associated than other areas. There were nearly 7,400 potentially HPV-associated cancers of the oral cavity and oropharynx per year – nearly 5,700 among men and about 1,700 among women. Incidence rates for a subset of the HPV-associated cancers of the oral cavity and oropharynx (cancers of the tonsil and cancers of the base of the tongue) were higher in men than women. These cancers significantly increased (3.0 percent) per year during the reporting period. 
• ANAL: There were more than 3,000 HPV-associated anal cancers per year – about 1,900 in women and 1,100 in men. HPV-associated anal cancer occurs more frequently among women (1.5) compared to men (1.0).  Whites had the highest rates among women (1.6), while blacks had the highest rates among men (1.2).
• VULVAR: There were about 2,300 new cases of vulvar cancer each year during the study period.  In contrast to cervical cancer, white women (1.8) had higher rates of vulvar cancer than black (1.3) and Asian/Pacific Islander (0.4) women.
• PENILE: Penile cancer is relatively rare, striking about 800 men each year.  Incidence rates were higher among Hispanic men (1.3) than non-Hispanic men (0.8).  
• VAGINAL: About 600 women a year developed vaginal cancers. Incidence rates were higher among black women than white women (0.7 and 0.4, respectively), and incidence rates were lowest among Asian/Pacific Islander women (0.3).
• Women with a history of cervical cancer have an increased risk of developing subsequent in situ (non-invasive) cancers of the vagina and vulva, as well as invasive cancers of the vagina, vulva, and rectum.

The Cancer supplement chapters also focus on disparities of HPV-associated cancers, how CDC and state and local programs address such disparities, background of the HPV vaccine, the economic impact of HPV-associated cancer mortality, the burden of cervical cancers in specific states with a high burden of disease, and surveillance of behavioral risk factors related to these cancers. These studies were conducted by scientists at CDC and several researchers at other organizations including the National Cancer Institute, the American Cancer Society, state cancer registry staff, and academic institutions.

For the online article, go to http://www3.interscience.wiley.com/journal/121498429/issue. For information on gynecologic cancers please visit www.cdc.gov/cancer/gynecologic.  For information on cervical cancer screening for low income, uninsured, and underinsured women, please visit http://www.cdc.gov/cancer/nbccedp/. For information on how men are affected by HPV-associated cancer, please visit http://www.cdc.gov/std/hpv/stdfact-hpv-and-men.htm.

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U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES