Incidence trends in head and neck cancers and human papillomavirus (HPV)-associated oropharyngeal cancer in Canada, 1992–2009

Forte, Tonia; Niu, Jin; Lockwood, Gina; Bryant, Heather

doi:10.1007/s10552-012-0013-z

Cited by 71 publications

(57 citation statements)

References 30 publications

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“…17 We observed that the increase in incidence of oropharyngeal cancer among men was twice that among women (annual percentage change 3.4 v. 1.5) between 1975 and 2009. Similarly, both Canadian 16 and US 18 data show that the increased incidence of HPV-associated head and neck cancers was greater among men, most notably the younger groups. In 2 previously reported Canadian studies, 16,17 ethnic minorities appeared to be at higher risk than the general population of both oropharyngeal cancer and oral cavity cancers.…”

Section: Cmaj Openmentioning

confidence: 88%

“…Similarly, both Canadian 16 and US 18 data show that the increased incidence of HPV-associated head and neck cancers was greater among men, most notably the younger groups. In 2 previously reported Canadian studies, 16,17 ethnic minorities appeared to be at higher risk than the general population of both oropharyngeal cancer and oral cavity cancers. In the US, non-Hispanic white and Hispanic populations experienced greater increases in the incidence of HPV-associated head and neck cancers than other groups.…”

Section: Cmaj Openmentioning

confidence: 88%

“…14,15 Data from the Canadian Cancer Registry show that the age-standardized incidence of HPV-associated oropharyngeal cancer increased from 1.6 per 100 000 in 1992 to 2.6 per 100 000 in 2009. 16 A recent study from British Columbia mirrors the overall Canadian trends. 17 We observed that the increase in incidence of oropharyngeal cancer among men was twice that among women (annual percentage change 3.4 v. 1.5) between 1975 and 2009.…”

Section: Cmaj Openmentioning

confidence: 97%

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Trends in the incidence of human papillomavirus-related noncervical and cervical cancers in Alberta, Canada: a population-based study

Shack¹,

Lau²,

Huang³

et al. 2014

CMAJ Open

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CMAJ OPEN, 2(3) E127 Research CMAJ OPENA ccording to world-wide estimates, human papillomavirus (HPV) infection is responsible for 5.2% of all cancers. 1,2 The association between HPV and cervical cancer has been well-known for many decades, but the link between HPV and cancers of the anus, penis, vagina, vulva and oropharynx has only recently been confirmed.3 Cervical cancer rates have been declining in Canada and the United States, consistent with the successful adoption of Papanicolaou smear screening programs, 4,5 but the incidence of other HPV-related cancers has been increasing. The increasing incidence of these HPV-related cancers has been attributed to changes in lifestyle-related risk factors, most notably sexual behaviour.5 Analysis of trends in incidence and birth cohorts in both the US and the United Kingdom have shown an increased risk of HPV-related cancer in more recent birth cohorts and recent time periods, 5,6 and these increases have been attributed to generational changes in sexual patterns and increased exposure to HPV. 6 HPV vaccines are now broadly used in the prevention of cervical cancer. In Alberta, HPV vaccination programs were implemented in 2008 and, as in many other jurisdictions, have been funded only for females. Although HPV vaccination programs may reduce the incidence of HPV-related cancers other than cervical cancer, 6 they remain the subject of much public policy debate in Canada. 7 In this study, we sought to examine trends in noncervical HPV-related cancers over time and compare them with relative changes in cervical cancer and non-HPV-related cancers with similar risk factors.

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Section: Cmaj Openmentioning

confidence: 88%

Section: Cmaj Openmentioning

confidence: 88%

Section: Cmaj Openmentioning

confidence: 97%

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Trends in the incidence of human papillomavirus-related noncervical and cervical cancers in Alberta, Canada: a population-based study

Shack¹,

Lau²,

Huang³

et al. 2014

CMAJ Open

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“…Global incidence rates of oropharyngeal cancer (OPC) are rising, particularly in economically developed countries such as Canada, United States, Japan, Switzerland, Australia, England and parts of Eastern Europe [3][4][5][6][7]. Rates of oral cavity cancer (OCC) are also rising among men and women in some European countries, stabilising in certain Asian countries and decreasing in Canada and USA [4,8].…”

Section: Introductionmentioning

confidence: 99%

Trends of oral cavity, oropharyngeal and laryngeal cancer incidence in Scotland (1975–2012) – A socioeconomic perspective

et al. 2016

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Aim: To examine current incidence trends of oral cavity (OCC), oropharyngeal (OPC) and laryngeal cancer in Scotland by socioeconomic status (SES). Methods:We included all diagnosed cases of OCC (C00.3-C00.9, C02-C06 excluding C2. rates increased markedly for OPC, decreased for laryn-geal cancer and remained stable for OCC, particularly in the last decade. Males exhibited significantly higher RRs compared to females, and the peak age of incidence of OPC was slightly lower than the other subsites. Conclusion:Contrary to reports that OPC exhibits an inverse socioeconomic profile, Scotland country-level data show that those from the most deprived areas consistently have the highest rates of head and neck cancers.3

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“…Although the increase in oropharyngeal cancer in Canada has been reported using Canadian national cancer registry data 12,13 , population-based studies allow only for inferences about the influence of hpv on changes in incidence. Centres across Canada have now begun routine testing of head-and-neck cancers for hpv, but the paper by Nichols and colleagues provides case-by-case information about the contribution of hpv to the dramatic increase in the oropharyngeal cancer incidence seen in Canada since the early 1990s.…”

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confidence: 99%

hpv is Here to Stay

Corsten¹

2013

Current Oncology

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Second, the markedly higher cure rates for hpvrelated tumours, and thus oropharyngeal cases in particular, have resulted in a shift from a concentration on survival to a concentration on quality of life and toxicity. Discussions about de-escalation of treatment for hpv-positive cases are now commonplace, and alternative, potentially less toxic, therapies including targeted agents and robotic surgery are being evaluated. Third, the realization that hpv-positive and hpvnegative head-and-neck cancer are essentially two different disease entities is accelerating the concept of "personalized medicine" in head-and-neck cancer, in which tumour and patient characteristics will be used to define individualized treatment regimens.Lastly, the realization that hpv infection is such an important causative agent in oropharyngeal cancer (in addition to cervical cancer) will have to inform the public health debate around vaccination programs, including the need for vaccinating men.The paper by Nichols et al. 11 in this issue of Current Oncology provides direct evidence of the increase in tonsillar cancers, and in hpv-positive cancers in particular, in a large Canadian academic health sciences centre over two decades (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011). Although the increase in oropharyngeal cancer in Canada has been reported using Canadian national cancer registry data 12,13 , population-based studies allow only for inferences about the influence of hpv on changes in incidence. Centres across Canada have now begun routine testing of head-and-neck cancers for hpv, but the paper by Nichols and colleagues provides case-by-case information about the contribution of hpv to the dramatic increase in the oropharyngeal cancer incidence seen in Canada since the early 1990s.The Nichols paper has limitations, as the authors indicate in their discussion. Cases were collected from a pathology database, the dynamics of which may have changed over time, and despite being in the database, a small number of cases were excluded because of tissue unavailability. A large number of other tonsillar cancer cases were excluded because Human papillomavirus (hpv) was first detected in head-and-neck cancers in the 1980s 1 . By 2001, Gillison and Shah-and others-had established clear evidence that hpv has a causal role in a significant subset of head-and-neck cancers 2 . Since then, it has become clear that hpv is associated primarily with oropharyngeal carcinomas, especially tonsillar cancers, and the proportion of oropharyngeal carcinomas considered to be associated with hpv has risen significantly 3 . Mounting evidence has also suggested that the cancers caused by hpv are substantially different in epidemiology, clinical behavior, response to treatment, and outcome than the typical smoking-related squamous-cell head-and-neck cancers treated previously. The hpv-related tumours, connected mostly to hpv-16 and -18, are seen in younger, healthier patients and usually in non-smok...

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Incidence trends in head and neck cancers and human papillomavirus (HPV)-associated oropharyngeal cancer in Canada, 1992–2009

Cited by 71 publications

References 30 publications

Trends in the incidence of human papillomavirus-related noncervical and cervical cancers in Alberta, Canada: a population-based study

Trends in the incidence of human papillomavirus-related noncervical and cervical cancers in Alberta, Canada: a population-based study

Trends of oral cavity, oropharyngeal and laryngeal cancer incidence in Scotland (1975–2012) – A socioeconomic perspective

hpv is Here to Stay

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