1. Todd, Betsy MPH, RN


* Decreasing cervical cancer rates may be associated with human papillomavirus (HPV) vaccine use.


* It may be too early to evaluate the association between HPV vaccine use and trends in oropharyngeal cancer in men.



Article Content

The human papillomavirus (HPV) vaccine was approved for use in women in 2006 and men in 2009. Researchers recently looked at a large national database for possible associations between HPV vaccination and the incidence of HPV-associated cancers.


This population-based study used cancer incidence data from U.S. Cancer Statistics, a compilation of the Centers for Disease Control and Prevention and National Cancer Institute surveillance data that represents 99% of the U.S. population. The researchers used HPV screening, vaccination, and hysterectomy data extracted from the Behavioral Risk Factor Surveillance System. The National Immunization Survey-Teen, a random-digit-dialed telephone survey of the parents and guardians of adolescents ages 13 to 17 years, provided teen vaccination data.


From 2001 to 2017, 657,317 cases of HPV-associated cancers were identified. Of those, 59.8% occurred in women and 40.2% occurred in men.


In women, cervical cancer accounts for more than half of HPV-associated cancers. During the past 17 years, the incidence of cervical cancer has been decreasing in all racial and ethnic groups and in all regions except the Midwest. Before HPV vaccine approval, the cervical cancer rates were decreasing at 2.29% in the 20-to-24-year-old age group. After vaccine approval, cervical cancer decreased at an annual rate of 9.5% in the same group.


Oropharyngeal cancer in men accounts for 80.1% of HPV-associated cancers, with an incidence of 8.89 per 100,000. During the past 17 years, the overall rate of oropharyngeal cancer in men has increased at an average annual rate of 2.71%. The rate has been increasing in White men (average annual increase, 3.48%) and decreasing in Black men (average annual decrease, 1.35%).


The decreasing incidence of cervical cancer, especially in younger women, may be associated with HPV vaccine use. In men, oropharyngeal cancer, which usually occurs later in life, is increasing. It may be too early to evaluate the association between HPV vaccination and trends in oropharyngeal cancer incidence.


This analysis did not provide information about possible confounding factors, such as sexual behavior and tobacco use.


Liao CI, et al JAMA Netw Open 2022;5(3):e222530.