J Natl Cancer Inst. 2023 Oct 18:djad214. doi: 10.1093/jnci/djad214. Online ahead of print.
ABSTRACT
BACKGROUND: Incidence of anal squamous cell carcinoma (SCC) is increasing, but vaccination against human papillomavirus (HPV) and removal of precancerous anal lesions could prevent new cases. The overall HPV-associated cancer incidence is reported to be higher in rural populations and in counties with lower economic status. We assessed these differences specifically for HPV-associated anal SCC and described the geographic, county-level economic, and sociodemographic variations in incidence rates and trends.
METHODS: We analyzed data from the United States Cancer Statistics to assess age-standardized incidence rates of HPV-associated SCCs among adults ≥18 years from 2001-2019. We calculated rate ratios and 95% confidence intervals to examine differences in incidence rates. We also quantified changes in incidence rates over time using joinpoint regression.
RESULTS: From 2001-2019, 72,421 new cases of HPV-associated anal SCC were diagnosed among women (2.8 per 100,000) and 37,147 among men (1.7 per 100,000). Age-standardized incidence rates were higher in the South compared to other census regions and in counties ranked in the bottom 25% and 25%-75% economically than in the top 25%. The overall incidence rate increased in women but remained stable in men during 2009-2019. Incidence rates increased in adults aged ≥50 years but decreased among those aged 40-44 years from 2001-2019 in women and from 2007-2019 in men.
CONCLUSIONS: There were inequities in HPV-associated anal SCC incidence by geographic and county-level economic characteristics. Failure to improve vaccine and treatment equity may widen existing disparities.
PMID:37851397 | DOI:10.1093/jnci/djad214
