title: Annual Report to the Nation on the Status of Cancer, 1975-2009, featuring the burden and trends in human papillomavirus(HPV)-associated cancers and HPV vaccination coverage levels.
abstract: BACKGROUND
  The American Cancer Society (ACS), the Centers for Disease Control and Prevention (CDC), the National Cancer Institute (NCI), and the North American Association of Central Cancer Registries (NAACCR) collaborate annually to provide updates on cancer incidence and death rates and trends in these outcomes for the United States. This year's report includes incidence trends for human papillomavirus (HPV)-associated cancers and HPV vaccination (recommended for adolescents aged 11-12 years).
  
  
  METHODS
  Data on cancer incidence were obtained from the CDC, NCI, and NAACCR, and data on mortality were obtained from the CDC. Long- (1975/1992-2009) and short-term (2000-2009) trends in age-standardized incidence and death rates for all cancers combined and for the leading cancers among men and among women were examined by joinpoint analysis. Prevalence of HPV vaccination coverage during 2008 and 2010 and of Papanicolaou (Pap) testing during 2010 were obtained from national surveys.
  
  
  RESULTS
  Death rates continued to decline for all cancers combined for men and women of all major racial and ethnic groups and for most major cancer sites; rates for both sexes combined decreased by 1.5% per year from 2000 to 2009. Overall incidence rates decreased in men but stabilized in women. Incidence rates increased for two HPV-associated cancers (oropharynx, anus) and some cancers not associated with HPV (eg, liver, kidney, thyroid). Nationally, 32.0% (95% confidence interval [CI] = 30.3% to 33.6%) of girls aged 13 to 17 years in 2010 had received three doses of the HPV vaccine, and coverage was statistically significantly lower among the uninsured (14.1%, 95% CI = 9.4% to 20.6%) and in some Southern states (eg, 20.0% in Alabama [95% CI = 13.9% to 27.9%] and Mississippi [95% CI = 13.8% to 28.2%]), where cervical cancer rates were highest and recent Pap testing prevalence was the lowest.
  
  
  CONCLUSIONS
  The overall trends in declining cancer death rates continue. However, increases in incidence rates for some HPV-associated cancers and low vaccination coverage among adolescents underscore the need for additional prevention efforts for HPV-associated cancers, including efforts to increase vaccination coverage.
authors.affiliation: Surveillance Research Program, American Cancer Society, 250 Williams St NW, Atlanta, GA 30303, USA. ajemal@cancer.org
authors.forename: Ahmedin
authors.initials: A
authors.lastname: Jemal
authors.forename: Edgar P
authors.initials: EP
authors.lastname: Simard
authors.forename: Christina
authors.initials: C
authors.lastname: Dorell
authors.forename: Anne-Michelle
authors.initials: AM
authors.lastname: Noone
authors.forename: Lauri E
authors.initials: LE
authors.lastname: Markowitz
authors.forename: Betsy
authors.initials: B
authors.lastname: Kohler
authors.forename: Christie
authors.initials: C
authors.lastname: Eheman
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
authors.forename: Priti
authors.initials: P
authors.lastname: Bandi
authors.forename: Debbie
authors.initials: D
authors.lastname: Saslow
authors.forename: Kathleen A
authors.initials: KA
authors.lastname: Cronin
authors.forename: Meg
authors.initials: M
authors.lastname: Watson
authors.forename: Mark
authors.initials: M
authors.lastname: Schiffman
authors.forename: S Jane
authors.initials: SJ
authors.lastname: Henley
authors.forename: Maria J
authors.initials: MJ
authors.lastname: Schymura
authors.forename: Robert N
authors.initials: RN
authors.lastname: Anderson
authors.forename: David
authors.initials: D
authors.lastname: Yankey
authors.forename: Brenda K
authors.initials: BK
authors.lastname: Edwards
mesh_terms: D000293:Adolescent; D001741:Black or African American / Q000706:statistics & numerical data; D017677:Age Distribution; D052685:Alphapapillomavirus; D001005:Anus Neoplasms / Q000453:epidemiology / Q000821:virology; D001213:Asian / Q000706:statistics & numerical data; D002423:Cause of Death; D017281:Cost of Illness; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data; D008297:Male; D009026:Mortality / Q000639:trends; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D009369:Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality / Q000517:prevention & control / Q000821:virology*; D009959:Oropharyngeal Neoplasms / Q000453:epidemiology / Q000821:virology; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000150:complications / Q000453:epidemiology* / Q000208:ethnology; D053918:Papillomavirus Vaccines / Q000008:administration & dosage*; D010412:Penile Neoplasms / Q000453:epidemiology / Q000821:virology; D018426:SEER Program; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000821:virology; D014625:Vaginal Neoplasms / Q000453:epidemiology / Q000821:virology; D014626:Vaginal Smears / Q000706:statistics & numerical data; D014846:Vulvar Neoplasms / Q000453:epidemiology / Q000821:virology
chemical_list: D053918:Papillomavirus Vaccines