Human papillomavirus associated anal squamous cell carcinoma: Sociodemographic, geographic, and county-level economic trends in incidence rates—United States, 2001–2019
Menée aux Etats-Unis sur la période 2001-2019, cette étude analyse les disparités géographiques et sociodémographiques dans l'incidence du carcinome épidermoïde de l'anus associé à une infection par le papillomavirus humain
Incidence of anal squamous cell carcinoma (SCC) is increasing, but vaccination against human papillomavirus (HPV) and removal of precancerous anal lesions could prevent new cases. The overall HPV-associated cancer incidence is reported to be higher in rural populations and in counties with lower economic status. We assessed these differences specifically for HPV-associated anal SCC and described the geographic, county-level economic, and sociodemographic variations in incidence rates and trends.We analyzed data from the United States Cancer Statistics to assess age-standardized incidence rates of HPV-associated SCCs among adults ≥18 years from 2001–2019. We calculated rate ratios and 95% confidence intervals to examine differences in incidence rates. We also quantified changes in incidence rates over time using joinpoint regression.From 2001–2019, 72,421 new cases of HPV-associated anal SCC were diagnosed among women (2.8 per 100,000) and 37,147 among men (1.7 per 100,000). Age-standardized incidence rates were higher in the South compared to other census regions and in counties ranked in the bottom 25% and 25%–75% economically than in the top 25%. The overall incidence rate increased in women but remained stable in men during 2009–2019. Incidence rates increased in adults aged ≥50 years but decreased among those aged 40–44 years from 2001–2019 in women and from 2007–2019 in men.There were inequities in HPV-associated anal SCC incidence by geographic and county-level economic characteristics. Failure to improve vaccine and treatment equity may widen existing disparities.