The Burden of HPV-Associated Anogenital Cancers

Abstract

The epidemiology of anogenital cancers is under going substantial change. Cervical cancer remains a major public health concern, particular in resource-limited settings. Cancers of the anus, penis, vagina and vulva are relatively uncommon cancers, but may be increasing in incidence. The change in occurrence of anogenital cancers may be due to increasing HPV transmission secondary to changes in sexual behaviour. Screening programmes and the HPV vaccine offer optimism that anogenital cancers can be prevented. This article reviews the epidemiology of anogenital cancers with a focus on Scottish data.

HPV status and favourable outcome in vulvar squamous cancer

“…These findings are consistent with previous work in Scotland which showed that the European age-standardised ratio for VSCC between 1972-1976 and 2007-2011, increased from 3.3 per 100,000 to 4.2 per 100,000 and that this increase was most prominent among younger women. 3 These data also reconcile with the US study, which assessed VSCC data from nine US Cancer registries for the period 1973-2004 and showed that VIN and VSCC increased 3.5% and 1.0% respectively, each year with the increase observed in all categories but the largest increase occurred in women aged 54 or less. 22 Reasons for this phenomenon are unclear at present.…”

“…2, 3 The reasons behind the changing epidemiology of vulval disease are unclear but it may be driven by a secular increase in HPV infection and/or changed behaviors that have facilitated the transmission.…”

Current state in the development of candidate therapeutic HPV vaccines

“…HPV is best known for its role in causing nearly 100% of cases of cervical cancer, which is the fourth most common cancer in women [1,2]. In addition, HPV has been indicated to be a human biologic carcinogen for 5 other types of cancers: penile, vaginal, vulvar, anal, and oropharynx including the base of the tongue and tonsils, with a high percentage of oropharyngeal cancer cases in the United States being attributed to HPV [1–4]. …”

Squamous cell carcinoma in the anophthalmic socket: a series of four cases with HPV-16 profiling

“…High-risk human papilloma virus is a well-established causative agent of a component of oropharyngeal carcinomas and cancers of the anogenital tract including cervical cancer 5. The association of HPV-16 and carcinomatous transformation was extended to the conjunctiva in 1989 when McDonnell and coworkers identified the virus in all patients investigated with conjunctival SCC 17.…”

“…The steps in HPV-driven carginogenesis include infection, persistence of infection, progression to premalignant lesions and invasion 5. In the absence of invasive disease, precursor lesions can be reversible.…”