Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA 30341, United States of America; Oak Ridge Institute for Science and Education, Oak Ridge, TN 37830, United States of America.
Adventist Health White Memorial Medical Center, Los Angeles, CA 90033, United States of America.
Prev Med. 2022 Nov;164:107302. doi: 10.1016/j.ypmed.2022.107302. Epub 2022 Oct 12.
Vulvar cancer incidence has been rising in recent years, possibly due to increasing exposure to human papillomavirus (HPV). We assessed incidence rates of HPV-associated and non-HPV-associated vulvar cancers diagnosed from 2001 to 2017 in the United States (US). Using population-based cancer registry data covering 99% of the US population, incidence rates were calculated and stratified by age, race/ethnicity, stage, geographic region, and histology. The average annual percent change in incidence per year were calculated using joinpoint regression. From 2001 to 2017, the incidence of HPV-associated vulvar cancers increased by 1.2% per year, most notably among women who were aged 50-59 years (2.6%), 60-69 years (2.4%), and ≥ 70 years (0.9%); of White (1.5%) and Black (1.1%) race; diagnosed at an early (1.3%) and late (1.8%) stage; and living in the Midwest (1.9%), Northeast (1.4%), and South (1.2%). Incidence increased each year for HPV-associated histologic subtypes including keratinizing (4.7%), non-keratinizing (6.0%), and basaloid (3.1%) squamous cell carcinomas (SCCs), while decreases were found in warty (2.7%) and microinvasive (5.5%) SCCs. HPV-associated vulvar cancer incidence increased overall and among women aged over 50 years while remaining stable among women younger than 50 years. The overall incidence for non-HPV-associated cancers was stable. Continued surveillance of HPV-associated cancers will allow us to monitor future trends as HPV vaccination coverage increases in the US.
近年来，外阴癌的发病率一直在上升，这可能是由于人类乳头瘤病毒（HPV）暴露的增加。我们评估了 2001 年至 2017 年期间美国 HPV 相关和非 HPV 相关外阴癌的发病率。利用覆盖美国 99%人口的基于人群的癌症登记数据，按年龄、种族/族裔、分期、地理区域和组织学进行了发病率分层。使用 joinpoint 回归计算了每年发病率的平均年度百分比变化。从 2001 年到 2017 年，HPV 相关外阴癌的发病率每年增长 1.2%，在 50-59 岁（2.6%）、60-69 岁（2.4%）和≥70 岁（0.9%）的女性中最为明显；在白种人（1.5%）和黑人（1.1%）中；在早期（1.3%）和晚期（1.8%）分期诊断；居住在中西部（1.9%）、东北部（1.4%）和南部（1.2%）。HPV 相关组织学亚型的发病率逐年上升，包括角化（4.7%）、非角化（6.0%）和基底细胞样（3.1%）鳞状细胞癌（SCC），而疣状（2.7%）和微浸润（5.5%）SCC 则下降。HPV 相关外阴癌的发病率总体上升，50 岁以上女性发病率上升，而 50 岁以下女性发病率保持稳定。非 HPV 相关癌症的总体发病率保持稳定。随着 HPV 疫苗接种在美国的覆盖范围不断扩大，对 HPV 相关癌症的持续监测将使我们能够监测未来的趋势。
