Semprini Jason, Benavidez Gabriel, Zahnd Whitney E, Brandt Heather M
Department of Public Health, Des Moines University College of Health Sciences, 8025 Grand Ave, West Des Moines, IA, 50266, USA.
Robbins College of Health and Human Sciences, Department of Public Health, Baylor University, Waco, TX, USA.
BMC Public Health. 2025 Aug 2;25(1):2627. doi: 10.1186/s12889-025-23963-y.
For decades, incidence of human papillomavirus (HPV)-associated cancers has been increasing in rural communities across the United States. Although emerging evidence shows a widening rural-urban disparity, rural intersectionality has been understudied. Our study examined the incidence of HPV-associated cancers within rural communities to identify differences by race/ethnicity for males and females, and explore how these differences varied by cancer type, socioeconomic, and geographic factors.
We accessed age-adjusted cancer incidence rates (2010-2019) from the North American Association of Central Cancer Registries (NAACCR) for HPV-associated cancers (cervical, vaginal, vulvar, penile, anal, oropharyngeal) in rural counties. Stratifying by sex, we calculated incidence rate ratios by race/ethnicity. Subgroup analyses included age, site, census-tract poverty, census tract socioeconomics, and region.
Between 2010 and 2019, rural HPV-associated cancer was 11.8 cases per 100,000 population. We found significant heterogeneity within male (10.5) and female (13.2) rates. For males, the lowest rate was found in non-Hispanic Asian-American/Pacific-Islander populations (3.7) and Hispanic populations (4.8), and the highest rate was found in non-Hispanic White populations (11.2). For females, the lowest rate was also found in Hispanic Asian-American/Pacific-Islander populations (8.8) and the highest rates were found in non-Hispanic Black (13.8) and non-Hispanic American Indian/Alaska Native populations (14.5). However, these racial/ethnic differences varied across rural subpopulations, geography, and poverty.
Appreciating the diversity of the rural cancer burden can be used to effectively develop and implement public health interventions to address HPV-related cancer disparities in rural communities. Actions are needed to prioritize reducing the burden of HPV-associated cancer in AIAN populations in high-poverty rural communities.
几十年来，美国农村社区人乳头瘤病毒（HPV）相关癌症的发病率一直在上升。尽管新出现的证据显示城乡差距不断扩大，但农村交叉性问题一直未得到充分研究。我们的研究调查了农村社区内HPV相关癌症的发病率，以确定男性和女性在种族/族裔方面的差异，并探讨这些差异如何因癌症类型、社会经济和地理因素而有所不同。
我们从北美中央癌症登记协会（NAACCR）获取了农村县HPV相关癌症（宫颈癌、阴道癌、外阴癌、阴茎癌、肛门癌、口咽癌）的年龄调整癌症发病率（2010 - 2019年）。按性别分层，我们计算了不同种族/族裔的发病率比。亚组分析包括年龄、部位、普查区贫困程度、普查区社会经济状况和地区。
2010年至2019年期间，农村HPV相关癌症的发病率为每10万人11.8例。我们发现男性（10.5）和女性（13.2）的发病率存在显著异质性。对于男性，非西班牙裔亚裔/太平洋岛民群体（3.7）和西班牙裔群体（4.8）的发病率最低，非西班牙裔白人群体（11.2）的发病率最高。对于女性，西班牙裔亚裔/太平洋岛民群体（8.8）的发病率也最低，非西班牙裔黑人（13.8）和非西班牙裔美国印第安人/阿拉斯加原住民群体（14.5）的发病率最高。然而，这些种族/族裔差异在农村亚人群、地理位置和贫困程度方面各不相同。
认识农村癌症负担的多样性可用于有效制定和实施公共卫生干预措施，以解决农村社区HPV相关癌症的差异。需要采取行动，优先减轻高贫困农村社区美洲印第安人和阿拉斯加原住民群体中HPV相关癌症的负担。
