Between 2012 and 2016, there were an estimated 34,800 annual cases of human papilloma virus (HPV)-related cancer in the United States, 92% of which were attributed to strains of the virus covered by the 9-valent HPV vaccine. However, approximately 50% of adolescents are not up-to-date on the recommendations for receiving this vaccine, according to a study published in Morbidity and Mortality Weekly Report.
The Centers for Disease Control and Prevention utilized data from US Cancer Statistics to determine the rate of incident cancer attributable to HPV infection, and to estimate the annual total of individuals with HPV-related cancers. All 50 states and the District of Columbia had high-quality data available from 2012 to 2016; the pool for this data included 100% of the US population.
The majority of cancer registries do not test for HPV. For this reason, cancers found in areas common to HPV such as the cervix, penis, vulva, vagina, oropharynx, and anus were classified as invasive cancers. The number of cancers attributable to HPV was estimated by taking the product of annual HPV-related cancer cases and the percentage of these cancers found to be attributable to HPV through genotyping. The study authors classified cancers as not attributable to HPV, those targeted by the 9-valent HPV vaccine (9vHPV), and those attributable to other types of HPV.
Of the 32,100 cases of potentially preventable cancers related to HPV infection (those cause by strains of HPV covered in the vaccine), 59% (n=19,000) of cases were in women. The most common types of cancer were cervical (n=9700) and oropharyngeal (n=12,600). Despite the ability of 9-valent HPV, designed to prevent these types of HPV-related cancers, in 2018 approximately half of adolescents were found to not be up-to-date with HPV vaccinations recommendations.
Researchers noted at least one limitation to this report: the lack of routine data collection on cancer tissue HPV genotype status; HPV-attributable cancers can only be approximated based on available estimates. However, as a result of using high-quality, population-base surveillance data, results all for generalizability to 100% of the US population.
The report authors concluded that “[among] the 43,999 HPV-associated cancers that occur each year in the United States, an estimated 34,800 are attributable to HPV,” and 92% of these cancers are targeted by 9vHPV. Both state-level data and HPV-related cancer surveillance are valuable tools for understanding the long-term effects of cervical cancer screening and HPV vaccination.
Senkomago V, Henley SJ, Thomas CC, Mix JM, Markowitz LE, Saraiya M. Human papillomavirus–attributable cancers — United States, 2012–2016. MMWE Morb Mortal Wkly Rep. 2019;68(33):724-728.