The burden of HPV associated cancers in two regions in Nigeria 2012–2014

Abstract

Introduction HPV attributable cancers are the second most common infection-related cancers worldwide, with much higher burden in less developed regions. There are currently no country-specific estimates of the burden of these cancers in Nigeria just like many other low and middle income countries. Methods In this study, we quantified the proportion of the cancer burden in Nigeria that is attributable to HPV infection from 2012 to 2014 using HPV prevalence estimated from previous studies and data from two population based cancer registries (PBCR) in Nigeria. We considered cancer sites for which there is strong evidence of an association with HPV infection based on the International Agency for Research on Cancer (IARC) classification. We obtained age and sex-specific estimates of incident cancers and using the World Standard Population, we derived age standardized incidence (ASR) rates for each cancer type by categories of sex, and estimated the population attributable fractions (PAF). Results The two PBCR reported 4336 new cancer cases from 2012 to 2014. Of these, 1627 (37.5%) were in males and 2709 (62.5%) in females. Some 11% (488/4336) of these cancers were HPV associated; 2% (38/1627) in men and 17% (450/2709) in women. Of the HPV associated cancers, 7.8% occurred in men and 92.2% in women. The ASRs for HPV associated cancers was 33.5 per 100,000; 2.3 and 31.2 per 100,000 in men and women respectively. The proportion of all cancers attributable to HPV infection ranged from 10.2 to 10.4% (442–453 of 4336) while the proportion of HPV associated cancers attributable to HPV infection ranged from 90.6% to 92.8% (442–453 of the 488 cases). In men, 55.3% to 68.4% of HPV associated cancers were attributable to HPV infection compared to 93.6% to 94.8% in women. The combined ASR for HPV attributable cancers ranged from 31.0 to 31.7 per 100,000. This was 1.4 to 1.7 per 100,000 in men and 29.6 to 30.0 per 100,000 in women. In women, cervical cancer (n = 392, ASR 28.3 per 100,000) was the commonest HPV attributable cancer, while anal cancer (n = 21, ASR 1.2 per 100,000) was the commonest in men. Conclusions HPV attributable cancers constitute a substantial cancer burden in Nigerian women, much less so in men. A significant proportion of cancers in Nigerian women would be prevented if strategies such as HPV DNA based screening and HPV vaccination are implemented.

The interplay of HIV and human papillomavirus-related cancers in sub-Saharan Africa: scoping review

“…The included studies comprise of review articles which made the bulk of the articles with 77.7% (7/9) [90][91][92][93][94][95][96] and (1/9) transversal case control study [97] and (1/9) quantitative study [98] and each contributed 11.1% respectively.…”

“…The studies were done and reviewed from different study settings. About 11.1% (1/9) study generalized about SSA with no specific country mentioned [90], 44% (4/9) reported about Uganda [91,92,95,96], 33% (3/9) South Africa (SA) [93,95,96], 22% (2/9) Senegal [94,96], (1/9) Zambia [93], (1/9) Nigeria [98], and (1/9) Benin [97], and each contributed 11% respectively. Among the included studies, only three were conducted in an urban setting; those of the rest of the studies were not mentioned.…”

“…The nine included studies showed evidence of cervical cancer among HIV-infected women and distribution of HPV infection and cervical abnormalities among HIVpositive individuals [90][91][92][93][94][95][96][97][98]. Five studies generalized about HIV and anal cancer [92-94, 96, 98]; only one reported about HIV and penile cancer [93].…”

“…Five studies generalized about HIV and anal cancer [92-94, 96, 98]; only one reported about HIV and penile cancer [93]. Two studies [93,98] generally reported about HIV and its association with head and neck cancers, and one [93] reported about vaginal cancer, vulvar cancer, and penile cancer. Figure 3 presents the number of included studies that reported on different anatomic cancer sites.…”

“…From the included ten studies, two primary studies underwent methodological quality assessment using the appropriate section of the Mixed Methods Appraisal Tool (MMAT)-Version 201 1 [25]. Both studies scored 100% [97,98] (Additional file 3: Table S3). The remaining eight included studies were not appraised for quality because they were not primary studies.…”