Cancers attributable to human papillomavirus infection.
Although the human papillomavirus (HPV) vaccine was introduced primarily as a cervical cancer prevention vaccine, HPV has a causal role in several types of cancer. This article reviews the epidemiological evidence for the role of HPV in human cancer, and describes Australian trends in these cancers. HPV is a necessary cause of cervical cancer. The currently vaccine-preventable subtypes of HPV 16 and 18 are responsible for ~70% of cervical cancer. The introduction of an organised Pap smear program in Australia led to a steep decline in incidence over the past decades. HPV can be detected in ~40% and 70% of vulval and vaginal cancers respectively. Rates of these cancers have been stable over the past 20 years. The prevalence of HPV in penile cancer is ~50% and incidence has not recently changed. For anal cancer, ~85% of cases are HPV positive, and incidence has increased significantly in both men and women over the past 20 years. In the oral cavity, ~35% of oropharyngeal cancers and ~25% of other oral cavity cancers are HPV positive. The incidence of HPV-related oral cavity and oropharyngeal cancers is increasing, whereas incidence at HPV-unrelated sites is decreasing. Overall, 1154 HPV-related cancer cases were potentially preventable by vaccination. If HPV-related cancers at non-cervical sites are prevented by vaccination, then a similar number of cancer cases will be prevented as in the cervix. However, almost one-quarter of the potentially preventable cancer cases are in men, who are not included in the current national immunisation program.
Grulich
Andrew E
AE
National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, NSW 2021, Australia. agrulich@nchecr.unsw.edu.au
Jin
Fengyi
F
Conway
E Lynne
EL
Stein
Alicia N
AN
Hocking
Jane
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001005:Anus Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000517:prevention & control; D002648:Child; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D052162:Human papillomavirus 16; D052161:Human papillomavirus 18; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000453:epidemiology* / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D010412:Penile Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D011159:Population Surveillance; D012737:Sex Factors; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology* / Q000517:prevention & control; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D014625:Vaginal Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D014626:Vaginal Smears; D014846:Vulvar Neoplasms / Q000453:epidemiology / Q000517:prevention & control; D055815:Young Adult; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology* / Q000517:prevention & control
D053918:Papillomavirus Vaccines