Human Papillomavirus–Attributable Cancers — United States, 2012–2016

Abstract

Human papillomavirus (HPV) causes nearly all cervical cancers and some cancers of the vagina, vulva, penis, anus, and oropharynx (1).*Most HPV infections are asymptomatic and clear spontaneously within 1 to 2 years; however, persistent infection with oncogenic HPV types can lead to development of precancer or cancer (2).In the United States, the 9-valent HPV vaccine (9vHPV) is available to protect against oncogenic HPV types 16, 18, 31, 33, 45, 52, and 58 as well as nononcogenic types 6 and 11 that cause genital warts.CDC analyzed data from the U.S. Cancer Statistics (USCS) † to assess the incidence of HPV-associated cancers and to estimate the annual number of cancers caused by HPV, overall and by state, during 2012-2016 (3,4).An average of 43,999 HPV-associated cancers were reported annually, and an estimated 34,800 (79%) of those cancers were attributable to HPV.Of these 34,800 cancers, an estimated 32,100 (92%) were attributable to the types targeted by 9vHPV, with 19,000 occurring among females and 13,100 among males.The most common were cervical (9,700) and oropharyngeal cancers (12,600).The number of cancers estimated to be attributable to the types targeted by 9vHPV ranged by state from 40 to 3,270 per year.HPV vaccination is an important strategy that could prevent these cancers, but during 2018, only half of adolescents were up to date on HPV vaccination (5).These surveillance data from population-based cancer registries can be used to inform the planning for, and monitor the long-term impact of, HPV vaccination and cancer screening efforts nationally and within states.CDC analyzed cancer incidence data from USCS, which includes cancer registry data from CDC's National Program of Cancer Registries and the National Cancer Institute's Surveillance, Epidemiology, and End Results Program.Data from the District of Columbia (DC) and all states met highquality data criteria for 2012-2016, covering 100% of the U.S. population.Invasive cancer cases were classified by anatomic site using the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) § (Supplementary Table, https://stacks.cdc.gov/view/cdc/80649) and were histologically confirmed.Cancers are not tested for HPV in most cancer registries; therefore, HPV-associated cancers were defined as invasive cancers at anatomic sites with cell types in which HPV DNA frequently is found, including carcinomas of the cervix *