Human papillomavirus-associated cancers in Taiwan over the last 18 years: The potential impact of screening, vaccination, and smoking.

Abstract

10574 Background: Human papillomavirus (HPV) is a causative agent of many human cancers. This study aims to determine the incidences and trends of HPV-associated cancers in the Republic of China. Methods: HPV-associated cancers included: cervical carcinoma, oropharyngeal squamous cell carcinoma (SCC), anal/rectal, vulvo-vaginal, and penile SCC. Deidentified data were obtained from Taiwan’s National Health Insurance Research Database from 2001 to 2018. SEER*Prep 2.6.0, SEER*Stat 8.3.9.2, and Joinpoint regression program 4.9.0.0 were used to calculate incidences and trends of HPV-associated cancers per 100,000. The age-adjusted incidence was adjusted by the WHO 2000 standard population. Results: A total of 55,248 HPV-associated cancers were identified. Of these, 34,730 (62.9%) were identified in women and 20,518 (37.1%) in men. The majority (60.0%) were cervical followed by oropharyngeal at 37.6%, and other HPV-associated cancers comprised 2.4%. Over the 18-year study, the overall age-adjusted incidence of HPV-associated cancers decreased from 13.41 to 8.92 (per/100,000) with an annual decrease of 2.02% ( P< 0.001). More specifically, cervical cancer incidence decreased from 20.42 to 7.70 per 100,000 with an annual decrease of 5.6% ( P< 0.001). Other cancers, such as vaginal and vulvar, decreased 2.34% ( P< 0.001) and 1.82% ( P< 0.001), respectively. With respect to oropharyngeal SCC, the incidence was over 12-fold higher in men compared to women (8.37 vs. 0.67/100,000) with both sexes increasing at 3.61% ( P< 0.001) and 3.59% ( P< 0.001) annually. Anal/rectal SCC increased at 3.55% ( P< 0.001) whereas penile cancer decreased at 2.52% ( P< 0.001). Of note, all HPV-associated cancers among non-smokers decreased 2.02% ( P< 0.001) annually, whereas they increased in smokers at 1.00% ( P> 0.05) per year. This increase in incidence was particularly evident in oropharyngeal SCC and cervical carcinomas. Conclusions: Women comprised over 60% of HPV related cancers, with cervical cancer being most common followed by oropharyngeal cancer. Over the last 18 years, cervical and vulvovaginal cancers decreased, but the rates of oropharyngeal cancers in men was 12-fold higher than women and continues to increase. Public awareness and education of these trends are needed toward prevention and screening.