Javadi Pardis, Sharma Arun, Zahnd Whitney E, Jenkins Wiley D
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, USA.
Population Health Science Program, Southern Illinois University School of Medicine, 201 E. Madison St., Springfield, IL, 62794-9664, USA.
Cancer Causes Control. 2017 Jun;28(6):635-645. doi: 10.1007/s10552-017-0889-8. Epub 2017 Apr 8.
Incidence rates of head and neck cancers (HNC) associated with human papillomavirus (HPVa) infection are increasing while non-HPV-associated (non-HPVa) HNC cancer rates are decreasing. As nearly all sexually active individuals will acquire an HPV infection, it is important to understand epidemiologic trends of HNCs associated with this sexually transmitted disease. We analyzed SEER 9 (1973-2012) and 18 data (2000-2012) for HPVa HNCs (oropharynx area; OP) and non-HPVa (oral cavity area; OC). Incidence rates were examined by gender, race, rurality, geographic location, and time. Joinpoint regression analyses assessed temporal variations. From 1973 to 2012, OC incidence decreased while OP increased, with changes largely driven by males (whose OP rate increased 106.2% vs female decrease of 10.3%). Males consistently had higher rates of both cancer groups across each registry except Alaska, OP rates among blacks changed from significantly above whites to below, and trend analysis indicated significant differences in rates over time by gender, race, and geography. Analysis of SEER 18 found that rates discordantly varied by group and gender across the 18 registries, as did the male/female rate ratio with overall means of 4.7 for OP versus 1.7 for OC (only Alaska and Georgia having overlapping ranges). Our findings indicate that much of the HPVa rate increases were driven by rate increases among males and that there were changing differences in risk between genders, race, and geographic location. The epidemiology of HNCs is complex, with locally relevant factors requiring further research for elucidation of demographic disparities in incidence.
与人乳头瘤病毒（HPV a）感染相关的头颈癌（HNC）发病率正在上升，而非HPV相关（非HPV a）的HNC癌症发病率则在下降。由于几乎所有性活跃个体都会感染HPV，因此了解与这种性传播疾病相关的HNC的流行病学趋势非常重要。我们分析了监测、流行病学和最终结果（SEER）9数据库（1973 - 2012年）以及18个数据（2000 - 2012年）中HPV a相关的HNC（口咽区域；OP）和非HPV a（口腔区域；OC）的数据。按性别、种族、农村/城市、地理位置和时间对发病率进行了检查。连接点回归分析评估了时间变化。从1973年到2012年，OC发病率下降而OP发病率上升，这种变化主要由男性驱动（男性OP发病率上升106.2%，而女性下降10.3%）。除阿拉斯加外，在每个登记处男性的这两种癌症发病率一直较高，黑人的OP发病率从显著高于白人变为低于白人，趋势分析表明按性别、种族和地理位置划分的发病率随时间存在显著差异。对SEER 18的分析发现，在这18个登记处中，发病率因组和性别而异，OP的男女发病率比总体均值为4.7，而OC为1.7（只有阿拉斯加和佐治亚州的范围有重叠）。我们的研究结果表明，HPV a发病率的大幅上升是由男性发病率上升驱动的，并且性别、种族和地理位置之间的风险差异正在发生变化。HNC的流行病学很复杂，当地相关因素需要进一步研究以阐明发病率方面的人口统计学差异。
