An analysis of the temporal, age, and gender trends in human papillomavirus virus (HPV)-related versus non-HPV-related head and neck cancers (HNC) in Alberta, Canada.

Abstract

e12505 Background: Recent epidemiologic studies have suggested that the incidence of HPV-associated HNC is increasing. This study assessed temporal, age-specific and gender specific changes in cancer incidence for HPV- versus non-HPV associated HNC compared with other HPV versus non-HPV associated malignancies in a population-based setting. Methods: We used the Alberta Cancer Registry, a population-based registry of all cancers diagnosed in the province of Alberta, Canada (population est. 3.6 million), to identify patients diagnosed with cancers of the oropharynx, cervix, vulva, vagina, anus, and penis (HPV-associated group) and compared this with non-oropharyngeal cancers of the head and neck and lung cancer (non-HPV associated, modifiable risk group) between January 1, 1975 and December 31, 2009. The age-standardized incidence rates (ASIR) for each cancer by gender and age-specific incidence was estimated with the annual percentage change (APC) assessed using Joinpoint regression. Results: The ASIR for oropharyngeal cancers (OPC) increased over time for both men (APC 3.5) and women (APC 1.5) with rapid increases seen in men under 35 (APC 27.3). Non-oropharyngeal squamous cell carcinomas of the head and neck had a higher ASIR overall with moderate temporal increases (APC 2.5) and age-specific increases highest in those aged 55 to 74. ASIR for anal canal cancers also increased over time, with greater increases amongst younger females, in contrast to OPC. By comparison, the ASIR of cervix cancer declined with more significant decreases in younger females; while the rates of other HPV-associated cancers (vulva, vagina, penile) showed little change. The ASIR for lung cancer decreased after 1987 (APC -1.5) for men and continued to moderately increase for women. Conclusions: Our findings suggest the greatest increases in OPC are occurring in younger men. Programs of HPV prevention such as vaccination should be explored to reduce the incidence of OPC in males.