Department of Veterans Affairs Medical Center, Oklahoma City, Oklahoma 73104, USA.
Cancer. 2013 Jun 15;119(12):2291-9. doi: 10.1002/cncr.27989. Epub 2013 Apr 11.
Population-based studies comprehensively describing incidence patterns of human papillomavirus (HPV)-related preinvasive and invasive neoplasms prior to widespread HPV vaccination are sparse.
Age-adjusted incidence rates (IRs), IR ratios (IRRs), and annual percent changes (APCs) in IRs were calculated for potentially HPV-related tumors diagnosed in the Surveillance, Epidemiology and End Results (SEER) Program during 1978 through 2007.
Overall IRs for preinvasive tumors were significantly higher than for invasive squamous cell tumors of cervix (IRR = 3.42), vulva (IRR = 1.87), and vagina (IRR = 1.19) and significantly lower for adenomatous cervical tumors (IRR = 0.43), and squamous cell tumors of penis (IRR = 0.64), anus (males, IRR = 0.53; females, IRR = 0.14), and head and neck (H&N) (males, IRR = 0.01; females, IRR = 0.02). Incidence of preinvasive squamous tumors of cervix, vagina, and penis rose rapidly over time and decreased for invasive neoplasms. The most rapid increases occurred for preinvasive (males, APC = 16.0; females, APC = 7.3) and invasive anal tumors (males, APC = 3.6; females, APC = 2.3). IR patterns were generally similar among evaluable racial/ethnic groups, with the exception of H&N invasive tumor IRs which increased exclusively among white males.
Contrary to the opposing trends of preinvasive and invasive squamous tumors of cervix, vagina, and penis, preinvasive and invasive anal tumor IRs increased significantly over time by sex, age, and racial/ethnic groups. Successful HPV vaccination programs are needed to measurably reduce incidence of HPV-related neoplasms in the future, particularly for cancer sites with rising incidence rates for which effective screening modalities are limited. Cancer 2013;119:2291-2299. © 2013 American Cancer Society.
在广泛使用 HPV 疫苗之前，全面描述人群中 HPV 相关的癌前和侵袭性肿瘤的发病模式的基于人群的研究很少。
计算了 1978 年至 2007 年期间，在监测、流行病学和最终结果（SEER）计划中诊断的潜在 HPV 相关肿瘤的年龄调整发病率（IR）、IR 比（IRR）和 IR 年百分比变化（APC）。
癌前肿瘤的总体 IR 明显高于宫颈（IRR=3.42）、外阴（IRR=1.87）和阴道（IRR=1.19）的侵袭性鳞状细胞肿瘤，明显低于宫颈腺瘤（IRR=0.43）和阴茎（IRR=0.64）、肛门（男性，IRR=0.53；女性，IRR=0.14）和头颈部（H&N）（男性，IRR=0.01；女性，IRR=0.02）的鳞状细胞肿瘤。宫颈、阴道和阴茎的癌前鳞状肿瘤的发病率随时间迅速上升，侵袭性肿瘤则下降。最迅速的增长发生在癌前（男性，APC=16.0；女性，APC=7.3）和侵袭性肛门肿瘤（男性，APC=3.6；女性，APC=2.3）。在可评估的种族/民族群体中，IR 模式通常相似，H&N 侵袭性肿瘤的 IR 除外，仅在白人男性中增加。
与宫颈、阴道和阴茎的癌前和侵袭性鳞状肿瘤的相反趋势相反，按性别、年龄和种族/民族群体划分，癌前和侵袭性肛门肿瘤的 IR 随时间显著增加。需要成功实施 HPV 疫苗接种计划，以便在未来可显著降低 HPV 相关肿瘤的发病率，特别是对于发病率上升且有效筛查方法有限的癌症部位。癌症 2013；119:2291-2299。© 2013 美国癌症协会。
