TABLE 2. Estimated number of human papillomavirus (HPV)–attributable cancers,* by sex, cancer type,† region, and HPV type,§ among American Indians and Alaska Natives¶ — Indian Health Service (IHS) Purchased/Referred Care Delivery Area (PRCDA)** counties, United States, 2013–2017.
| Characteristic | Estimated no. |
||
|---|---|---|---|
| 9vHPV-targeted | Other HPV | HPV-negative | |
|
All HPV-associated cancers
|
740
|
90
|
200
|
| Sex | |||
| Female |
500 |
50 |
100 |
| Male |
240 |
40 |
100 |
| Cancer type | |||
| Cervix |
330 |
40 |
40 |
| Vagina |
10 |
<10 |
<10 |
| Vulva |
50 |
10 |
30 |
| Oropharynx |
230 |
40 |
110 |
| Anus |
100 |
<10 |
10 |
| Penis |
20 |
<10 |
10 |
| Region | |||
| Northern Plains |
130 |
20 |
40 |
| Alaska |
60 |
10 |
20 |
| Southern Plains |
210 |
30 |
60 |
| Pacific Coast |
180 |
20 |
50 |
| East |
50 |
10 |
10 |
| Southwest | 110 | 10 | 30 |
Abbreviations: 9vHPV = 9-valent HPV vaccine; ICD-O-3 = International Classification of Diseases for Oncology, Third Edition.
* HPV-attributable cancers are cancers that are probably caused by HPV (https://academic.oup.com/jnci/article/107/6/djv086/872092). Estimates for attributable fraction were based on studies that used population-based data from cancer tissue studies to estimate the percentage of those cancers probably caused by HPV.
† HPV-associated cancers were defined as invasive cancers at anatomic sites with cell types in which HPV DNA frequently is found. All cancers were histologically confirmed. Cervical cancers (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 (ICD-O-3 site codes 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).
§ “9vHPV-targeted” includes oncogenic HPV types 16, 18, 31, 33, 45, 52, and 58. “Other HPV” includes other oncogenic HPV types. “HPV-negative” cancers are those that occur at anatomic sites in which HPV-associated cancers are often found, but HPV DNA was not detected. The estimated number of HPV-attributable cancers was calculated by multiplying the number of HPV-associated cancer cases by the percentage of each cancer type attributable to HPV, grouped as types targeted by 9vHPV and other HPV types. HPV-negative estimates were the difference of the total count and the HPV-attributable estimates. Estimates were rounded to the nearest 10; estimates <10 are not displayed.
¶ AI/AN race was reported by cancer registries or identified through linkage with the IHS patient registration database. To minimize racial/ethnic misclassification, analyses were restricted to AI/AN of non-Hispanic origin.
** Compiled from data for 2013–2017 from 50 states and the District of Columbia in cancer registries that met data quality criteria and linked with the IHS patient registration database; based on patients who resided in a PRCDA-designated county. States that have at least one PRCDA-designated county, by region and percentage of total AI/AN population residing in PRCDA counties, include Alaska (100%) (Alaska), Pacific Coast (60.3%) (California, Idaho, Oregon, and Washington), Southwest (83.9%) (Arizona, Colorado, Nevada, New Mexico, and Utah), Northern Plains (54.3%) (Indiana, Iowa, Michigan, Minnesota, Montana, Nebraska, North Dakota, South Dakota, Wisconsin, and Wyoming), Southern Plains (56.7%) (Kansas, Oklahoma, and Texas), and East (16.8%) (Alabama, Connecticut, Florida, Louisiana, Maine, Massachusetts, Mississippi, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, and Virginia). In the United States, 53.3% of the AI/AN population reside in PRCDA counties.