Despite the decline in cancer death rates in the U.S., there is an increase in incidence rates for cancers associated with human papillomavirus
(HPV) infection and more efforts are needed to increase HPV vaccination
coverage levels to prevent the occurrence of these cancers in the
future according to a study published January 7 in the Journal of the National Cancer Institute.
The American Cancer Society (ACS), the Centers for Disease Control and
Prevention (CDC), the National Cancer Institute (NCI), and the North
American Association of Central Cancer Registries (NAACCR) annually
provide updates on trends in cancer incidence and death rates in the
United States. This year's report highlighted trends in incidence rates
for HPV associated cancers and HPV vaccination coverage levels. Two HPV
vaccines (bivalent and quadrivalent) have been shown to protect against
most cervical cancers in women and one vaccine (quadrivalent) also
protects against genital warts
and cancers of the anus, vagina and vulva. There is no data available
on vaccine efficacy for prevention HPV-associated cancers of the
oropharynx.
In order to assess trends in HPV-associated cancer incidence rates and
HPV vaccination coverage levels, Ahmedin Jemal, D.V.M., Ph.D.,
Surveillance Research Program, American Cancer Society, Atlanta, GA.,
and colleagues examined cancer incidence data reported by the CDC, and
NCI, through NAACCR, as well as cancer mortality data from the CDC. The
researchers determined trends in age-standardized incidence and death
rates for all cancers combined and for the leading cancers among men and
women, while HPV vaccination coverage levels during 2008 and 2010 and
the prevalence of Papanicolaou (Pap) testing during 2010 were obtained
from national surveys.
During 2000-2009, the researchers found that overall cancer death rates
in the U.S. continue to decrease (including for lung, colorectal, female
breast, and prostate cancers), but that death rates have increased for cancers of the liver, pancreas, uterine corpus, and melanoma
of the skin among males. The incidence rates for these cancers
continued to increase as well, including for some cancers associated
with HPV infection. Nationally, 32.0% of females aged 13-17 years had
received three doses of the HPV vaccine in 2010 showing the necessity
for increased efforts to increase HPV vaccination coverage. "Continued
monitoring of incidence and mortality trends for all cancers is
warranted to inform cancer prevention and control policies and
programs," the authors conclude.
In an accompanying editorial, Marc Brisson, Ph.D., Centre de recherche
du CHU de Québec, Hôpital Saint-Sacrement, Québec, Canada, and
colleagues write that HPV vaccination efforts should be focused on
females because it's been predicted to be the most effective way to
ensure population-level vaccine effectiveness. "Finding ways to
increasing vaccine uptake is a key priority for HPV-related public
health research in the United States."
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