Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
Department of Premedicine and Allied Health Professions, Davidson College, Davidson, NC, USA.
JNCI Cancer Spectr. 2023 Mar 1;7(2). doi: 10.1093/jncics/pkad012.
Asian Americans and Native Hawaiians and other Pacific Islanders have suboptimal human papillomavirus (HPV) vaccination and cancer screening rates. Asian Americans and NHPIs are often aggregated, masking disparities characterized by varying colonization and immigration patterns and cultural and religious beliefs between populations and ethnicities. We examined the incidence of HPV-associated cancers across disaggregated Asian American and NHPI ethnicities.
Using the Surveillance, Epidemiology, and End Results Detailed Asian/Pacific Islander database, we calculated 1990 to 2014 sex-specific, age-standardized HPV-associated cancer incidence of cervical carcinoma, oropharyngeal squamous cell carcinoma (SCC), vulvar SCC, vaginal SCC, anal SCC, and penile SCC by ethnicity: Asian Indian and Pakistani, Chinese, Filipino, Japanese, Kampuchean, Korean, Laotian, Native Hawaiian, other Pacific Islander, and Vietnamese. Trends by calendar period (1990 to 1996, 1997 to 2002, 2003 to 2008, 2009 to 2014) were estimated using Joinpoint regression.
The most common HPV-associated cancer was cervical carcinoma in women and oropharyngeal SCC in men. During 1990 to 2014, cervical carcinoma incidence per 100 000 ranged from 4.5 (Asian Indian and Pakistani) to 20.7 (Laotian). Cervical carcinoma incidence only statistically significantly declined for Asian Indian and Pakistani, Filipino, Korean, Laotian, and Vietnamese women (range = 19.9% to 44.1% decline per period). Among men, oropharyngeal SCC incidence per 100 000 ranged from 1.1 (Chinese) to 5.1 (Native Hawaiian). Oropharyngeal SCC incidence only statistically significantly increased (31.0% increase per period) for Japanese men. Heterogeneity across ethnicities were observed for other cancer sites.
HPV-associated cancer incidence varied widely between Asian Americans and NHPIs and by ethnicity, underscoring the need for improved data capture of ethnic groups in research and more tailored interventions to better address health disparities between Asian American and NHPI populations.
亚裔美国人、夏威夷原住民和其他太平洋岛民的人乳头瘤病毒 (HPV) 疫苗接种率和癌症筛查率不理想。由于不同的殖民和移民模式以及不同人群和族裔的文化和宗教信仰，亚裔美国人和 NHPIs 经常被归为一类，掩盖了由此造成的差异。我们研究了不同族裔的亚裔美国人和夏威夷原住民中 HPV 相关癌症的发病率。
利用监测、流行病学和最终结果详细的亚太裔数据库，我们按族裔计算了 1990 年至 2014 年宫颈癌、口咽鳞状细胞癌 (SCC)、外阴 SCC、阴道 SCC、肛门 SCC 和阴茎 SCC 与 HPV 相关的癌症发病率：印度裔和巴基斯坦裔、华裔、菲律宾裔、日裔、高棉裔、韩裔、老挝裔、夏威夷原住民、其他太平洋岛民和越南裔。使用 Joinpoint 回归估计了 1990 年至 1996 年、1997 年至 2002 年、2003 年至 2008 年和 2009 年至 2014 年的日历期趋势。
最常见的 HPV 相关癌症是女性宫颈癌和男性口咽 SCC。1990 年至 2014 年，女性每 100000 人中有 4.5 例（印度裔和巴基斯坦裔）至 20.7 例（老挝裔）宫颈癌。只有印度裔和巴基斯坦裔、菲律宾裔、韩裔、老挝裔和越南裔女性的宫颈癌发病率有统计学意义的下降（每个时期下降 19.9%至 44.1%）。男性每 100000 人中口咽 SCC 发病率为 1.1（华裔）至 5.1（夏威夷原住民）。只有日本男性的口咽 SCC 发病率有统计学意义的上升（每个时期上升 31.0%）。其他癌症部位的发病率在不同族裔之间存在差异。
HPV 相关癌症的发病率在亚裔美国人和夏威夷原住民以及不同族裔之间差异很大，这突显出需要在研究中更好地记录族裔群体的数据，并采取更有针对性的干预措施，以更好地解决亚裔美国人和夏威夷原住民群体之间的健康差距。
