Jedy-Agba E E, Dareng E O, Adebamowo S N, Odutola M, Oga E A, Igbinoba F, Otu T, Ezeome E, Bray F, Hassan R, Adebamowo C A
Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom.
Center for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, United Kingdom.
Cancer Epidemiol. 2016 Dec;45:91-97. doi: 10.1016/j.canep.2016.10.008. Epub 2016 Oct 22.
HPV attributable cancers are the second most common infection-related cancers worldwide, with much higher burden in less developed regions. There are currently no country-specific estimates of the burden of these cancers in Nigeria just like many other low and middle income countries.
In this study, we quantified the proportion of the cancer burden in Nigeria that is attributable to HPV infection from 2012 to 2014 using HPV prevalence estimated from previous studies and data from two population based cancer registries (PBCR) in Nigeria. We considered cancer sites for which there is strong evidence of an association with HPV infection based on the International Agency for Research on Cancer (IARC) classification. We obtained age and sex-specific estimates of incident cancers and using the World Standard Population, we derived age standardized incidence (ASR) rates for each cancer type by categories of sex, and estimated the population attributable fractions (PAF).
The two PBCR reported 4336 new cancer cases from 2012 to 2014. Of these, 1627 (37.5%) were in males and 2709 (62.5%) in females. Some 11% (488/4336) of these cancers were HPV associated; 2% (38/1627) in men and 17% (450/2709) in women. Of the HPV associated cancers, 7.8% occurred in men and 92.2% in women. The ASRs for HPV associated cancers was 33.5 per 100,000; 2.3 and 31.2 per 100,000 in men and women respectively. The proportion of all cancers attributable to HPV infection ranged from 10.2 to 10.4% (442-453 of 4336) while the proportion of HPV associated cancers attributable to HPV infection ranged from 90.6% to 92.8% (442-453 of the 488 cases). In men, 55.3% to 68.4% of HPV associated cancers were attributable to HPV infection compared to 93.6% to 94.8% in women. The combined ASR for HPV attributable cancers ranged from 31.0 to 31.7 per 100,000. This was 1.4 to 1.7 per 100,000 in men and 29.6 to 30.0 per 100,000 in women. In women, cervical cancer (n=392, ASR 28.3 per 100,000) was the commonest HPV attributable cancer, while anal cancer (n=21, ASR 1.2 per 100,000) was the commonest in men.
HPV attributable cancers constitute a substantial cancer burden in Nigerian women, much less so in men. A significant proportion of cancers in Nigerian women would be prevented if strategies such as HPV DNA based screening and HPV vaccination are implemented.
人乳头瘤病毒（HPV）相关癌症是全球第二大常见的感染相关癌症，在欠发达地区负担要高得多。与许多其他低收入和中等收入国家一样，目前尼日利亚尚无针对这些癌症负担的具体国家估计数据。
在本研究中，我们利用先前研究估计的HPV流行率以及尼日利亚两个人口癌症登记处（PBCR）的数据，对2012年至2014年尼日利亚归因于HPV感染的癌症负担比例进行了量化。我们根据国际癌症研究机构（IARC）的分类，考虑了有充分证据表明与HPV感染相关的癌症部位。我们获得了特定年龄和性别的新发癌症估计数，并使用世界标准人口，按性别类别得出每种癌症类型的年龄标准化发病率（ASR），并估计了人群归因分数（PAF）。
两个PBCR报告了2012年至2014年的4336例新癌症病例。其中，1627例（37.5%）为男性，2709例（62.5%）为女性。这些癌症中约11%（488/4336）与HPV相关；男性为2%（38/1627），女性为17%（450/2709）。在与HPV相关的癌症中，7.8%发生在男性，92.2%发生在女性。HPV相关癌症的ASR为每10万人33.5例；男性和女性分别为每10万人2.3例和31.2例。归因于HPV感染的所有癌症比例在10.2%至10.4%之间（4336例中的442 - 453例），而归因于HPV感染的与HPV相关癌症比例在90.6%至92.8%之间（488例中的442 - 453例）。在男性中，55.3%至68.4%的与HPV相关癌症归因于HPV感染，而女性为93.6%至94.8%。HPV归因癌症的综合ASR在每10万人31.0至31.7例之间。男性为每10万人1.4至1.7例，女性为每10万人29.6至30.0例。在女性中，宫颈癌（n = 392，ASR为每10万人28.3例）是最常见的HPV归因癌症，而在男性中，肛门癌（n = 21，ASR为每10万人1.2例）是最常见的。
HPV归因癌症在尼日利亚女性中构成了相当大的癌症负担，在男性中则要少得多。如果实施基于HPV DNA的筛查和HPV疫苗接种等策略，尼日利亚女性中很大一部分癌症将得以预防。
