HPV-Associated Cancers in Florida: Epidemiologic Data before Implementation of HPV Vaccination

BACKGROUND:  Human papillomavirus (HPV) is associated with cervical, vulvar, vaginal, penile, anal, and oropharyngeal cancers.  Recently introduced HPV vaccination has been demonstrated to be highly effective in preventing cancers due to HPV types 6, 11, 16 and 18.  The implementation of HPV vaccination may change the occurrences and distribution of HPV types among the population, and the epidemiologic patterns of HPV-associated cancers.  The purpose of this study is to provide baseline data on HPV-related cancers in Florida before large scale HPV vaccination is implemented.

METHODS:  Data on cervical, vulvar, vaginal, penile, anal, and oropharyngeal cancers in 2001-2010 were collected by the Florida Cancer Data System. Age-adjusted incidence rates were calculated by county, race and sex (when appropriate).  Age-specific rates were calculated for age groups 0-44 years, 45-64 years, 65-74 years and 75+ years.

RESULTS:  There were 4,123 anal cancer cases, 9,056 cervical cancer cases, 1,399 oropharyngeal cancer cases, 815 penile cancer cases, 763 vaginal cancer cases and 2,630 vulvar cancer cases in 2001-2010.  The age-adjusted rates were less than 3/100,000 for all HPV associated cancers, except cervical cancer (>7.7/100,000). Compared to blacks, whites had a higher age-adjusted incidence rate for anal cancer and vulvar cancer, but a lower rate of cervical, vaginal and penile cancers.  Only cervical cancer rates decreased among both white and black women in the 10-year time period. No time trend of change in other cancer incidence rates was observed.

CONCLUSIONS:  A total of 18,186 cases of HPV-associated cancers were diagnosed in 2001-2010.  Implementation of HPV vaccination may reduce the burden of these cancers in Florida in the future.  Current patterns of cancer distribution need to be monitored in order to identify populations to be targeted for prevention via vaccination.