Gopalani Sameer Vali, Senkomago Virginia, Rim Sun Hee, Saraiya Mona
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Oak Ridge Institute for Science and Education, Oak Ridge, TN, USA.
J Natl Cancer Inst. 2024 Feb 8;116(2):275-282. doi: 10.1093/jnci/djad214.
Incidence of anal squamous cell carcinoma is increasing, but vaccination against human papillomavirus (HPV) and removal of precancerous anal lesions could prevent new cases. The overall HPV-associated cancer incidence is reported to be higher in rural populations and in counties with lower economic status. We assessed these differences specifically for HPV-associated anal squamous cell carcinoma and described the geographic, county-level economic, and sociodemographic variations in incidence rates and trends.
We analyzed data from the US Cancer Statistics to assess age-standardized incidence rates of HPV-associated squamous cell carcinomas among adults aged 18 years and older from 2001 to 2019. We calculated rate ratios and 95% confidence intervals to examine differences in incidence rates. We also quantified changes in incidence rates over time using joinpoint regression.
From 2001 to 2019, 72 421 new cases of HPV-associated anal squamous cell carcinoma were diagnosed among women (2.8 per 100 000) and 37 147 among men (1.7 per 100 000). Age-standardized incidence rates were higher in the South compared with other census regions and in counties ranked in the bottom 25% and 25%-75% economically than in the top 25%. The overall incidence rate increased in women but remained stable in men during 2009-2019. Incidence rates increased in adults aged 50 years and older but decreased among those aged 40-44 years from 2001 to 2019 in women and from 2007 to 2019 in men.
There were inequities in HPV-associated anal squamous cell carcinoma incidence by geographic and county-level economic characteristics. Failure to improve vaccine and treatment equity may widen existing disparities.
肛门鳞状细胞癌的发病率正在上升，但人乳头瘤病毒（HPV）疫苗接种和癌前肛门病变切除可预防新发病例。据报道，农村人口和经济地位较低的县中，HPV相关癌症的总体发病率较高。我们专门评估了HPV相关肛门鳞状细胞癌的这些差异，并描述了发病率和趋势在地理、县级经济和社会人口统计学方面的差异。
我们分析了美国癌症统计数据，以评估2001年至2019年18岁及以上成年人中HPV相关鳞状细胞癌的年龄标准化发病率。我们计算了率比和95%置信区间，以检验发病率差异。我们还使用连接点回归量化了发病率随时间的变化。
2001年至2019年，女性中有72421例新诊断的HPV相关肛门鳞状细胞癌病例（每10万人中有2.8例），男性中有37147例（每10万人中有1.7例）。与其他普查地区相比，南部地区的年龄标准化发病率更高，经济排名后25%和25%-75%的县高于前25%的县。2009年至2019年期间，女性的总体发病率上升，而男性保持稳定。2001年至2019年，50岁及以上成年人的发病率上升，但40-44岁人群的发病率下降，女性为2001年至2019年，男性为2007年至2019年。
HPV相关肛门鳞状细胞癌的发病率在地理和县级经济特征方面存在不平等。未能改善疫苗和治疗的公平性可能会扩大现有的差距。
