Department of Otolaryngology, University of Kentucky, Lexington, KY, USA.
Department of Biostatistics, University of Kentucky, Lexington, KY, USA.
Cancer Causes Control. 2024 May;35(5):817-824. doi: 10.1007/s10552-023-01835-3. Epub 2024 Jan 12.
Populations with high cancer risk that are targeted for screening, education, and vaccination have been shown to increase rates of screening, which ultimately may improve timing of diagnosis and overall outcome for certain cancers. Spatial scan analysis provides a visual representation of areas with higher rates of disease. Limited research has used this methodology to assess HPV-associated cancers. Using, spatial scan statistics, our goal was to identify regions within Kentucky having significantly higher rates of HPV-associated tumors. These regions can be targeted for public health efforts in the form of education, vaccination, screening, and physician recruitment.
The Kentucky Cancer Registry data from 1995 to 2016 and spatial scan statistics were used to identify county-level clusters with high-incidence of HPV-associated cancers after adjustment for age and sex. Anatomic sites included in this analysis were oropharynx, cervix, anus, penis, and vulva.
There was one high-rate cluster of oropharyngeal cancer, which was observed in the Louisville metropolitan region (Relative Risk [RR] = 1.24, p < 0.001). One high-rate cluster of anal and penile cancer incidence in men was identified that partially overlapped with the oropharyngeal cluster. There were five clusters of higher cervical, vulvar, and anal cancer incidence in females, one of which overlapped with the oropharyngeal cluster.
Overlapping clusters of HPV-associated cancers were identified at the county-level and included both urban and rural counties of Kentucky. Findings can assist in the design of public health interventions to increase screenings, promote vaccination, and recruit physicians in these regions to improve prevention, diagnosis, and early treatment of HPV-associated cancers.
针对具有高癌症风险的人群进行筛查、教育和疫苗接种，已被证明可以提高筛查率，这最终可能改善某些癌症的诊断时机和整体预后。空间扫描分析提供了疾病高发区域的直观表示。有限的研究使用这种方法评估了 HPV 相关癌症。本研究使用空间扫描统计，旨在确定肯塔基州内 HPV 相关肿瘤发病率较高的区域。这些区域可以通过健康教育、疫苗接种、筛查和医生招募等公共卫生措施来进行针对性干预。
本研究使用了 1995 年至 2016 年的肯塔基州癌症登记数据和空间扫描统计，在调整年龄和性别因素后，确定 HPV 相关癌症发病率较高的县一级集群。本分析中包含的解剖部位有口咽、宫颈、肛门、阴茎和外阴。
在路易斯维尔大都市区观察到一个口咽癌高发集群（相对风险 [RR] = 1.24，p < 0.001）。还确定了一个与口咽癌集群部分重叠的男性肛门和阴茎癌高发集群。在女性中，有五个宫颈癌、外阴癌和肛门癌发病率较高的集群，其中一个与口咽癌集群重叠。
在县一级确定了 HPV 相关癌症的重叠集群，其中包括肯塔基州的城市和县。这些发现可以帮助设计公共卫生干预措施，以提高筛查率，促进疫苗接种，并在这些地区招募医生，从而改善 HPV 相关癌症的预防、诊断和早期治疗。
