Incidence, Trends and Ethnic Differences of Oropharyngeal, Anal and Cervical Cancers: Singapore, 1968-2012

In recent decades, several Western countries have reported an increase in oropharyngeal and anal cancers caused by human papillomavirus (HPV). Trends in HPV-associated cancers in Asia have not been as well described. 

We describe the epidemiology of potentially HPV-related cancers reported to the Singapore Cancer Registry from 1968–2012. Analysis included 998 oropharyngeal squamous cell carcinoma (OPSCC), 183 anal squamous cell carcinoma (ASCC) and 8,019 invasive cervical cancer (ICC) cases. Additionally, 368 anal non-squamous cell carcinoma (ANSCC) and 2,018 non-oropharyngeal head and neck carcinoma (non-OP HNC) cases were included as comparators. 

Age-standardized incidence rates (ASR) were determined by gender and ethnicity (Chinese, Malay and Indian). Joinpoint regression was used to evaluate annual percentage change (APC) in incidence. OPSCC incidence increased in both genders (men 1993–2012, APC = 1.9%, p<0.001; women 1968–2012, APC = 2.0%, p = 0.01) and was 5 times higher in men than women. In contrast, non-OP HNC incidence declined between 1968–2012 among men (APC = -1.6%, p<0.001) and women (APC = -0.4%, p = 0.06). ASCC and ANSCC were rare (ASR = 0.2 and 0.7 per 100,000 person-years, respectively) and did not change significantly over time except for increasing ANSCCs in men (APC = 2.8%, p<0.001). ICC was the most common HPV-associated cancer (ASR = 19.9 per 100,000 person-years) but declined significantly between 1968–2012 (APC = -2.4%). Incidence of each cancer varied across ethnicities. 

Similar to trends in Western countries, OPSCC incidence increased in recent years, while non-OP HNC decreased. ICC remains the most common HPV-related cancer in Singapore, but Pap screening programs have led to consistently decreasing incidence.

Below:  Incidence of oropharyngeal and non-oropharyngeal head and neck squamous cell carcinomas in Singapore 1968–2012, by gender

Below:  Incidence of invasive anal cancer in Singapore, 1968–2012, by gender and histology

Below:  Incidence of invasive cervical cancer in Singapore, 1968–2012, by ethnicity

Full article at:   http://goo.gl/d8E8Xy

By:   

Jennifer O. Lam, Gypsyamber D’Souza

Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, United States of America

Wei-Yen Lim

Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore

Khuan-Yew Chow

National Registry of Diseases Office, Singapore, Singapore

More at:  https://twitter.com/hiv insight

And: http://twitter.com/Prison Health

Concurrence of Oral & Genital Human Papillomavirus Infection in Healthy Men: A Population-Based Cross-Sectional Study in Rural China

Human papillomavirus (HPV) infection, a primary cause of genital cancer, is also related to the increasing incidence of oropharyngeal cancer among young men. Relatively little is known about the concurrence of oral and genital infection among healthy individuals. 

Oral and genital swab exfoliated cells were collected simultaneously from 2566 men in rural China. Using general primer-mediated (SPF1/GP6+) PCR and sequencing, HPV testing results were obtained from 2228 men with both valid oral and genital specimens (β-globin-positive). 

The prevalence of HPV infection was 6.7% in the oral cavity and 16.9% for the external genitalia. Among 43 men (1.9%, 43/2228) with oral-genital coinfection, 60.5% (26/43) harbored an identical HPV type at both sites. T

he risk of oral HPV infection was higher among men with genital infection than among uninfected men (11.4% vs. 5.7%, Adjusted OR = 2.3, 95% CI: 1.6–3.4). In addition, having multiple lifetime sexual partners was a significant risk for oral-genital HPV coinfection (Adjusted OR = 2.6, 95% CI: 1.0–7.0; 2 partners vs. 1 partner). 

These findings provide a basis for further understanding the natural history and transmission dynamics of oral HPV infection.

Full article at: http://goo.gl/qgrIOz

By: Fangfang Liu,1,* Dong Hang,2,* Qiuju Deng,1,* Mengfei Liu,1 Longfu Xi,3,4 Zhonghu He,1 Chaoting Zhang,1 Min Sun,1Ying Liu,1 Jingjing Li,1 Yaqi Pan,1 Tao Ning,1 Chuanhai Guo,1 Yongmei Liang,1 Ruiping Xu,5 Lixin Zhang,5 Hong Cai,a,1 and Yang Keb,1

¹Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Laboratory of Genetics, Peking University Cancer Hospital & Institute, Beijing, China

²Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, China

³Department of Epidemiology, School of Public Health, University of Washington, Seattle, WA, USA

⁴Department of Pathology, School of Medicine, University of Washington, Seattle, WA, USA

⁵Anyang Cancer Hospital, Anyang, Henan Province, People’s Republic of China

^aEmail: moc.liamg@iachrd

^bEmail: nc.ude.umjb@gnayek

  

More at:  https://twitter.com/hiv_insight

HPV Prevalence in Multiple Anatomical Sites among Men Who Have Sex with Men in Peru

Human Papilloma Virus (HPV) infection is the most common sexually transmitted viral infection worldwide. HPV is highly prevalent in sexually active men who have sex with men (MSM) and has been associated with anal cancer, penile cancer, and oropharyngeal cancer.

From March to September 2011, we conducted a cross-sectional study of HPV prevalence among MSM above age 18 years. Participants were recruited using respondent driven sampling at Clinica Cayetano Heredia. All participants provided anal, genital, and oral samples for HPV DNA testing, and blood for HIV and HPV antibody testing.

A total of 200 MSM were recruited in the study. The mean age was 34 years (range 18–59 years, SD = 9.4) and101 participants were HIV negative (99 HIV positive). HPV 6/11/16/18 or quadrivalent HPV vaccine (HPV4) genotype seroprevalence among HIV negative and positive MSM was 64.3% (55%-75.9%) and 93.8% (87.6%-99.2%) respectively (p<0.001). HIV positivity was associated with a higher prevalence of HPV4 and HPV 16/18 DNA at external genital sites and the anal canal. HPV4 DNA prevalence at external genital sites among HIV negative and positive MSM was 14.9% and 28.7% (p = 0.02) respectively, at anal canal was 50.9% and 79.0% (p = 0.001), and at the oral cavity was 9.9% and 8.5% (p = 0.6).

HPV4 seroprevalence was high in our study among both HIV positives and negatives, with HPV DNA prevalence much lower, and the anal canal being the anatomical site with the highest HPV DNA prevalence. HPV prevention interventions are needed among MSM at high-risk for HIV infection.

Below:  Representation of the seeds and their referred participants

Full article at: http://goo.gl/CpyYCy

By: 

Magaly M. Blas, Luis Menacho, Isaac E. Alva, Cesar Carcamo

Epidemiology, STD and HIV Unit, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru

Brandon Brown

Center for Healthy Communities, UCR School of Medicine, Riverside, California, United States of America

Alfonso Silva-Santisteban

Unit of Health, Sexuality and Human Development, School of Public Health and Administration, Universidad Peruana Cayetano Heredia, Lima, Peru

More at:  https://twitter.com/hiv_insight