TABLE 2. Annual number, annual age-adjusted rate,* and trends† of HPV-associated cancer cases,§ by sex, race, ethnicity,¶ and U.S. census region** — United States,†† 1999–2015.
| Cancer type/Characteristic | 1999 |
2015 |
1999–2015 |
|---|---|---|---|
| No. (rate) | No. (rate) | AAPC (95% CI) | |
|
Females
| |||
|
Cervical carcinoma
| |||
|
Race
| |||
| White |
10,316 (8.8) |
9,079 (7.1) |
-1.5† (-2.0 to -1.0) |
| Black |
2,114 (13.4) |
1,731 (7.9) |
-3.2† (-3.8 to -2.5) |
| AI/AN |
96 (8.8) |
117 (5.9) |
-1.7† (-2.7 to -0.6) |
| API |
442 (8.7) |
616 (5.8) |
-2.9† (-3.4 to -2.4) |
|
Ethnicity
| |||
| Non-Hispanic |
11,293 (8.8) |
9,706 (7.0) |
-1.5† (-1.9 to -1.0) |
| Hispanic |
1,831 (15.2) |
2,082 (8.9) |
-3.4† (-3.9 to -2.9) |
|
Region
| |||
| Northeast |
2,571 (8.8) |
2,140 (6.9) |
-1.7† (-2.0 to -1.4) |
| Midwest |
2,901 (8.9) |
2,498 (7.3) |
-1.7† (-2.3 to -1.0) |
| South |
4,935 (10.1) |
4,601 (7.7) |
-1.7† (-2.1 to -1.3) |
| West |
2,718 (8.8) |
2,549 (6.6) |
-2.0† (-2.6 to -1.4) |
|
Vulvar SCC
| |||
|
Race
| |||
| White |
2,394 (1.8) |
3,485 (2.2) |
1.5† (1.3 to 1.7) |
| Black |
186 (1.2) |
289 (1.3) |
1.0† (0.2 to 1.8) |
| AI/AN |
7 (0.7) |
20 (1.1) |
—§§ |
| API |
20 (0.5) |
46 (0.5) |
0.5 (-1.3 to 2.3) |
|
Ethnicity
| |||
| Non-Hispanic |
2,510 (1.8) |
3,679 (2.1) |
1.6† (1.3 to 1.8) |
| Hispanic |
105 (1.2) |
211 (1.1) |
-0.1 (-0.8 to 0.6) |
|
Region
| |||
| Northeast |
618 (1.9) |
847 (2.2) |
1.5† (1.1 to 2.0) |
| Midwest |
687 (1.9) |
1,024 (2.4) |
1.5† (0.5 to 2.5) |
| South |
855 (1.7) |
1,366 (2.0) |
1.3† (1.0 to 1.7) |
| West |
455 (1.5) |
653 (1.5) |
0.3 (-0.2 to 0.9) |
|
Vaginal SCC
| |||
|
Race
| |||
| White |
583 (0.4) |
638 (0.4) |
-0.3 (-0.9 to 0.3) |
| Black |
125 (0.9) |
124 (0.6) |
-2.7† (-4.0 to -1.4) |
| AI/AN |
—§§ |
—§§ |
—§§ |
| API |
14 (0.4) |
29 (0.3) |
-2.1 (-4.6 to 0.4) |
|
Ethnicity
| |||
| Non-Hispanic |
682 (0.5) |
724 (0.4) |
-0.5 (-1.0 to 0.1) |
| Hispanic |
48 (0.5) |
85 (0.4) |
-1.7† (-2.8 to -0.6) |
|
Region
| |||
| Northeast |
148 (0.5) |
154 (0.4) |
-0.7 (-1.6 to 0.3) |
| Midwest |
165 (0.5) |
161 (0.4) |
-0.1 (-1.1 to 1.0) |
| South |
297 (0.6) |
327 (0.5) |
-0.9† (-1.7 to -0.1) |
| West |
120 (0.4) |
167 (0.4) |
-0.5 (-1.4 to 0.3) |
|
Anal SCC
| |||
|
Race
| |||
| White |
1,904 (1.5) |
4,010 (2.4) |
3.2† (2.8 to 3.6) |
| Black |
175 (1.2) |
378 (1.6) |
2.2† (1.4 to 2.9) |
| AI/AN |
8 (1.0) |
22 (1.1) |
—§§ |
| API |
21 (0.5) |
47 (0.4) |
-0.9 (-3.5 to 1.8) |
|
Ethnicity
| |||
| Non-Hispanic |
2,001 (1.5) |
4,192 (2.4) |
3.2† (2.8 to 3.6) |
| Hispanic |
128 (1.4) |
315 (1.5) |
0.5 (-0.1 to 1.2) |
|
Region
| |||
| Northeast |
374 (1.2) |
855 (2.2) |
4.3† (2.7 to 6.0) |
| Midwest |
465 (1.3) |
979 (2.3) |
3.6† (3.0 to 4.1) |
| South |
815 (1.6) |
1,689 (2.3) |
2.6† (2.1 to 3.0) |
| West |
475 (1.6) |
984 (2.1) |
2.2† (1.6 to 2.8) |
|
Oropharyngeal SCC
| |||
|
Race
| |||
| White |
2,090 (1.7) |
3,022 (1.9) |
1.2† (0.9 to 1.5) |
| Black |
282 (1.9) |
303 (1.3) |
-1.7† (-2.3 to -1.2) |
| AI/AN |
7 (0.8) |
15 (0.9) |
—§§ |
| API |
22 (0.5) |
56 (0.5) |
0.9 (-0.8 to 2.6) |
|
Ethnicity
| |||
| Non-Hispanic |
2,306 (1.7) |
3,251 (1.8) |
1.0† (0.7 to 1.2) |
| Hispanic |
103 (1.1) |
187 (0.9) |
0.1 (-1.1 to 1.3) |
|
Region
| |||
| Northeast |
524 (1.7) |
659 (1.8) |
1.1† (0.6 to 1.7) |
| Midwest |
536 (1.6) |
813 (1.9) |
1.5† (1.0 to 2.0) |
| South |
887 (1.8) |
1,348 (1.9) |
0.7† (0.4 to 1.0) |
| West |
462 (1.5) |
618 (1.4) |
-0.2 (-0.5 to 0.1) |
|
Males
| |||
|
Penile SCC
| |||
|
Race
| |||
| White |
864 (0.9) |
1,045 (0.8) |
-0.1 (-0.7 to 0.4) |
| Black |
71 (0.7) |
124 (0.8) |
-0.2 (-1.3 to 0.9) |
| AI/AN |
10 (2.1) |
8 (0.5) |
—§§ |
| API |
15 (0.5) |
27 (0.3) |
-0.9 (-3.3 to 1.5) |
|
Ethnicity
| |||
| Non-Hispanic |
865 (0.8) |
1,029 (0.7) |
-0.3 (-0.8 to 0.2) |
| Hispanic |
108 (1.4) |
195 (1.1) |
-0.9 (-2.0 to 0.2) |
|
Region
| |||
| Northeast |
180 (0.8) |
222 (0.8) |
0 (-1.0 to 0.9) |
| Midwest |
240 (0.9) |
267 (0.8) |
-0.5 (-2.0 to 0.9) |
| South |
387 (1.0) |
486 (0.8) |
-0.8 (-1.9 to 0.3) |
| West |
166 (0.7) |
249 (0.7) |
0.2 (-0.6 to 0.9) |
|
Anal SCC
| |||
|
Race
| |||
| White |
1,008 (0.9) |
1,870 (1.3) |
2.1† (1.6 to 2.5) |
| Black |
136 (1.1) |
315 (1.7) |
3.0† (1.2 to 4.7) |
| AI/AN |
—§§ |
12 (0.6) |
—§§ |
| API |
7 (0.2) |
16 (0.2) |
1.0 (-1.5 to 3.5) |
|
Ethnicity
| |||
| Non-Hispanic |
1,093 (1.0) |
2,072 (1.4) |
2.3† (1.6 to 3.1) |
| Hispanic |
75 (0.8) |
164 (0.8) |
-0.1 (-1.1 to 1.0) |
|
Region
| |||
| Northeast |
246 (1.0) |
485 (1.6) |
2.7† (2.0 to 3.4) |
| Midwest |
230 (0.8) |
400 (1.1) |
2.7† (1.9 to 3.4) |
| South |
431 (1.0) |
884 (1.4) |
2.3† (1.6 to 3.0) |
| West |
261 (1.0) |
467 (1.2) |
0.8 (-0.1 to 1.6) |
|
Oropharyngeal SCC
| |||
|
Race
| |||
| White |
5,871 (5.5) |
13,979 (9.2) |
3.3† (3.1 to 3.6) |
| Black |
944 (8.3) |
1,135 (6.1) |
-1.6† (-2.0 to -1.2) |
| AI/AN |
36 (4.7) |
82 (4.4) |
2.5† (0.9 to 4.1) |
| API |
78 (2.0) |
166 (1.9) |
1.1† (0.1 to 2.1) |
|
Ethnicity
| |||
| Non-Hispanic |
6,635 (5.8) |
14,728 (9.1) |
3.0† (2.8 to 3.2) |
| Hispanic |
330 (4.2) |
751 (4.1) |
0.1 (-0.5 to 0.7) |
|
Region
| |||
| Northeast |
1,367 (5.5) |
2,710 (8.0) |
2.6† (2.4 to 2.9) |
| Midwest |
1,569 (5.4) |
3,423 (8.5) |
3.2† (2.9 to 3.6) |
| South |
2,677 (6.3) |
6,183 (9.4) |
2.5† (2.3 to 2.8) |
| West | 1,353 (5.1) | 3,163 (7.4) | 2.6† (2.3 to 2.9) |
Sources: CDC’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program.
Abbreviations: AAPC = average annual percent change; AI/AN = American Indian/Alaska Native; API = Asian or Pacific Islander; CI = confidence interval; SCC = squamous cell carcinoma.
* Per 100,000 persons, age-adjusted to the 2000 U.S. standard population.
† Significant at p<0.05. Trends were measured with AAPC in rates and were considered to increase or decrease if p<0.05; otherwise rates were considered stable.
§ HPV-associated cancers were defined as cancers at specific anatomic sites with specific cell types in which HPV DNA frequently is found. All cancers were microscopically confirmed. Cervical cancers (International Classification of Diseases for Oncology, Third Edition [ICD-O-3] site codes C53.0–C53.9) are limited to carcinomas (ICD-O-3 histology codes 8010–8671, 8940–8941). Vaginal (ICD-O-3 site code C52.9), vulvar (ICD-O-3 site codes C51.0–C51.9), penile (ICD-O-3 site codes C60.0–60.9), anal (including rectal SCC; ICD-O-3 site code C20.9, C21.0–C21.9), and oropharyngeal (ICD-O-3 site codes C01.9, C02.4, C02.8, C05.1, C05.2, C09.0, C09.1, C09.8, C09.9, C10.0, C10.1, C10.2, C10.3, C10.4, C10.8, C10.9, C14.0, C14.2 and C14.8) cancer sites are limited to squamous cell carcinomas (ICD-O-3 histology codes 8050–8084, 8120–8131).
¶ Racial categories are not mutually exclusive from Hispanic ethnicity. Rates are not presented for cases with unknown or other race or unknown ethnicity.
** Midwest: Illinois, Indiana, Iowa, Kansas, Michigan, Minnesota, Missouri, Nebraska, North Dakota, Ohio, and Wisconsin. Northeast: Connecticut, Maine, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, and Vermont. South: Alabama, Delaware, District of Columbia, Florida, Georgia, Kentucky, Louisiana, Maryland, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Virginia, and West Virginia. West: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Montana, Nevada, New Mexico, Oregon, Utah, Washington, and Wyoming.
†† Cancer incidence compiled from cancer registries that meet the data quality criteria for all invasive cancer sites combined (covering approximately 97.8% of the U.S. population).
§§ Data suppressed for rates when the number of cases was <6 in a year.