Cancer attributable to human papillomavirus infection in China: Burden and trends

Abstract

Background Human papillomavirus (HPV) is associated with a substantial percentage of cervical cancer, and a significant percentage of anal, penile, vaginal, vulvar, oral cavity, oropharyngeal, and laryngeal cancers. Understanding the burden and trends of HPV‐attributable cancers is crucial to HPV prevention strategies. In the current study, the authors estimated the latest burden and trends of HPV‐attributable cancers in China. Methods Data from the following sources were used. The number of new cancer cases and cancer deaths in China were estimated based on the China Cancer Registry Annual Report. The population‐attributable fraction was estimated using pooled high‐risk HPV prevalence and biomarker‐positive rates, which were calculated using random effects meta‐analyses. Cancer burden estimates were stratified by anatomic site, sex, and age. Results In 2015, a total of 110,650 new cancer cases and 36,714 cancer deaths attributable to HPV infection were estimated to have occurred in China, of which cervical cancer accounted for 85.6% and 78.1%, respectively. The age‐standardized incidence rate (ASIR) and age‐standardized mortality rate (ASMR) of HPV‐attributable cancers were 5.63 and 1.81 per 100,000 person‐years, respectively. The ASIR and ASMR both varied by anatomic site, with the highest rates noted for cervical cancer at 4.83 and 1.42 per 100,000 person‐years, respectively. Between 2005 and 2015, the ASIR and ASMR demonstrated significant upward trends for all HPV‐attributable cancers combined. Conclusions Between 2005 and 2015, cervical cancer accounted for the vast majority of HPV‐attributable cancers and its incidence and mortality increased rapidly in China. The comprehensive prevention of cervical cancer remains the most important target in the prevention of HPV‐attributable cancers.