Incidence trends of human papillomavirus‐related head and neck cancer in Taiwan, 1995–2009

Recent studies suggested that human papillomavirus (HPV) is an emerging risk factor of head and neck cancer (HNC), particularly for oropharyngeal cancer. Studies from the West showed a rising trend of HPV‐related HNC despite a decrease of the overall HNC incidence. In contrast, the overall HNC incidence in Taiwan has continued to rise. It is not clear whether the incidence trends of HPV‐related HNC in Taiwan have a similar pattern to those from countries with an overall decreasing incidence of HNC. This study examined the incidence trends of HPV‐related and HPV‐unrelated HNC in Taiwan using data from the Taiwan Cancer Registry. Our results showed that the incidence trends of HPV‐related and HPV‐unrelated HNC in Taiwan both rose during 1995–2009. The incidence of HPV‐related HNC (1.3 per 100,000 in 1995 to 3.3 in 2009, annual percentage change (APC) = 6.9, p < 0.0001) rose more rapidly than the incidence of HPV‐unrelated HNC (10.4 per 100,000 in 1995 to 21.7 in 2009, APC = 5.0, p < 0.0001). The rising trend of HPV‐related HNC was particularly prominent for HNC occurring in tonsil (APC = 8.2, p < 0.0001), in men (APC = 7.5, p < 0.0001), and in those aged between 40 and 50 years (APC = 8.5, p < 0.0001). Although the overall incidence of HNC in Taiwan has continued to increase, the most rapid rise is in the HPV‐related HNC. This suggests that similar to the Western world, HPV‐related HNC is becoming an important public health issue in Taiwan.     

Incidence trends for potentially human papillomavirus‐related and ‐unrelated head and neck cancers in France using population‐based cancer registries data: 1980–2012

Human papillomavirus (HPV) has been recently recognised as a carcinogenic factor for a subset of head and neck cancers (HNC). In Europe, France has one of the highest incidence rates of HNC. The aim of this study is to explore changes in HNC incidence in France, potentially in relation with infection by HPV. HNC were classified into two anatomical groups: potentially HPV‐related and HPV‐unrelated. Trends over the period 1980–2012 were analysed by an age‐period‐cohort model based on data from eleven French cancer registries. Among men, the age‐standardised incidence rate (ASR) of HNC decreased in both groups, but less so for HPV‐related sites as compared to unrelated sites, especially in recent years (annual percentage change [APC] over the period 2005–2012: ?3.5% vs . ?5.4%). Among women, the ASR increased in both groups, but more rapidly for HPV‐related as compared to unrelated sites (APC over the period 2005–2012: +1.9% vs . ?0.4%). This preferential growth of HPV‐related versus unrelated HNC was observed in the cohorts born from 1930 to 1935. The differences in trends between possible HPV‐related and HPV‐unrelated sites suggest an increasing incidence of HNC due to HPV infection. The difference was less marked in men as compared to women, most likely because of a higher contamination in the HPV‐related group by cancers due to tobacco or alcohol consumption. The pattern observed is consistent with observations made in other countries, with studies of HPV prevalence in HNC and the evolution of sexual behaviour in France.     

Trends in head and neck cancer incidence in Denmark, 1978-2007: focus on human papillomavirus associated sites

The aim of our study was to assess the overall trends in the incidence of head-and-neck cancer (HNC) among Danish men and women in 1978-2007, to describe the distribution and incidences of HNCs at different anatomical sites, and to determine whether the incidence of human papillomavirus (HPV)-associated cancers is increasing. Data were extracted from the nationwide Cancer Registry database. To assess the possible impact of HPV infection, the sites of squamous cell carcinomas were categorized as HPV-associated, potentially HPV-associated or HPV-unrelated. In total, 26,474 incident cases were identified and the overall incidence increased throughout the period. Significantly increasing incidence rates were notably seen for tumors in the oral cavity (2.2% per year), tonsils (4.8% per year), oropharynx (3.5% per year) and hypopharynx (4.4% per year). A significantly decreasing incidence of lip cancer was observed among men (-5.0% per year). Cancers at HPV-associated sites (n = 3650) showed strongly increasing incidence rates, primarily in individuals < 60 years. In contrast, HNCs at sites not related to HPV infection showed a significant decrease (in men) or virtually no change in incidence (in women). Our results suggest a marked impact of HPV infection on the epidemiology of HNCs in Denmark. HPV16 is the type most often found in HNCs; thus, the recent introduction of vaccination against HPV may in the future prevent HPV-associated cancers of the head and neck.     

Population-based evidence of increased survival in human papillomavirus-related head and neck cancer

BackgroundEvidence from clinical, population-based and molecular studies has shown that human papillomavirus (HPV) infection can be a causal risk factor for a subset of head and neck squamous cell carcinomas (HNSCC). It is proposed that HPV-associated oropharyngeal cancer is a new disease entity that requires treatment and prevention strategies distinct from present recommendations.MethodsIn our population-based study we estimated incidence and survival trends in 8270 patients with HPV-related HNSCC (HPV⁺HNSCC) and HPV-unrelated HNSCC (HPV^–HNSCC) in Norway over the past three decades.ResultsIn the period 1981–1995, patients with HPV⁺HNSCC had poorer survival than HPV^–HNSCC (adjusted hazard ratio (HR) 1.3, 95% confidence interval (CI): 1.14–1.44). By 1996–2007, survival had increased in both groups, but the increase was significantly greater among HPV⁺HNSCC patients (HR 0.57, 95% CI: 0.48–0.67). During the same period, incidence also increased, but only for HPV⁺HNSCCs. From 1981–1995 to 1996–2007, median age at diagnosis for HPV⁺HNSCC decreased from 63.2 to 59.8 years, while for HPV^–HNSCC median age at diagnosis of 66.6 years remained unchanged.ConclusionsWe demonstrate a population level improvement in survival among patients with oropharyngeal squamous cell cancers commonly related to infection with HPV. In contrast, patients with HNSCC not related to HPV only showed a modest improvement in survival in the period 1981–2007. A concomitant increase in incidence and survival was observed for HPV-related cancers only. This trend cannot be explained by changes in treatment, cancer registration nor screening, but is most likely due to an increased prevalence of HPV-positive tumours.     

Esophageal and gastric cancer incidence trends in Golestan,Iran: An age-period-cohort analysis 2004 to 2018

Golestan province in the northeast of Iran is part of the Asian esophageal cancer belt and is known as a high-risk area for esophageal (EC) and gastric cancers (GC). Data on incident cases of EC and GC during 2004 to 2018 were obtained from the Golestan Population-based Cancer Registry (GPCR). The age-standardized incidence rates (ASRs) were calculated and presented per 100 000 person-years. The estimated annual percentage change (EAPC) with 95% confidence interval (95% CI) were calculated. We also fitted age-period-cohort (APC) models to assess nonlinear period and cohort effects as incidence rate ratios (IRRs). Overall, 3004 new cases of EC (ASR = 15.7) and 3553 cases of GC (ASR = 18.3) were registered in the GPCR. We found significant decreasing trends in incidence rates of EC (EAPC = −5.0; 95% CI: −7.8 to −2.2) and less marked nonsignificant trends for GC (EAPC = −1.4; 95% CI: −4.0 to 1.4) during 2004 to 2018. There was a strong cohort effect for EC with a consistent decrease in the IRR across successive birth cohorts, starting with the oldest birth cohort (1924; IRR = 1.9 vs the reference birth cohort of 1947) through to the most recent cohort born in 1988 (IRR = 0.1). The marked declines in EC incidence rates in Golestan relate to generational changes in its underlying risk factors. Despite favorable trends, this population remains at high risk of both EC and GC. Further studies are warranted to measure the impact of the major risk factors on incidence with a view to designing effective preventative programs.     

上海市浦东新区1996~2007年前列腺癌流行趋势分析

[目的]分析上海市浦东新区1996～2007年前列腺癌发病、死亡的流行趋势及其特点,为防治工作提供科学依据.[方法]对1996～2007年浦东新区前列腺癌发病和死亡资料进行分析,计算发病(死亡)粗率、标化发病(死亡)率、年平均增长率、变化百分比(PC)和年度变化百分比(APC).[结果]浦东新区前列腺癌标化发病率1996～2007年间年平均增长率为12.15％,PC为70.69％,APC为7.8903％ (t=3.2703,P＜0.01).城区、城镇前列腺癌发病年平均增长率分别为10.60％、16.68％,PC分别为69.37％、396.24％,APC分别为6.4751％、11.1684％ (P＜0.05).前列腺癌标化死亡率12年间年平均增长率为5.65％,PC为33.72％,APC为3.0806％ (t=1.7070,P ＞0.05),城区、城镇前列腺癌死亡年平均增长率分别为3.81％、8.47％,PC分别为41.69％、120.15％,APC分别为4.7539％、5.1550％ (P＞0.05).前列腺癌发病、死亡均集中在60岁以上各年龄组.[结论]上海浦东新区前列腺癌发病呈现上升趋势,城镇高于城区;前列腺癌死亡未呈现上升趋势.60岁以上的男性是前列腺癌重点防治对象.     

2001-2019年深圳市南山区结直肠癌发病及趋势分析

目的:了解深圳市南山区2001-2019年结直肠癌发病的流行特征及变化趋势，为针对性开展结直肠癌防治提供参考依据。方法:根据深圳市慢性病防治管理系统登记的2001-2019年南山区常住户籍人口诊断为结直肠癌的所有病例数据，计算结直肠癌粗发病率、中标率、世标率、年龄别发病率。采用Joinpoint回归分析结直肠癌发病的时间趋势，计算年度发病变化百分比（annual percent change，APC）。结果:南山区2001-2019年共报告结直肠癌新发病例1 732例，粗发病率16.96/10万，中标率23.16/10万，世标率23.79/10万。男女发病比为1.46∶1，不同性别间的年龄别发病率均呈上升趋势。结直肠癌发病率随着年龄增长而升高，0~69岁的人群发病率上升趋势尤为显著， 85岁及以上的人群发病率则达到高峰。世标率从2001年的13.30/10万上升至2019年的35.20/10万，Joinpoint结果显示，2001-2019年结直肠癌的世标率APC为3.91%（P＜0.01）。结论:南山区结直肠癌发病形势严峻，为降低其发病率，结直肠癌筛查及早诊早治工作应要积极落实推进。     

HPV-related oropharyngeal cancers: From pathogenesis to new therapeutic approaches

Head and neck cancers are a heterogeneous group of malignancies accounting for approximately 600,000 new cases every year worldwide. Human papillomavirus (HPV)-related oropharyngeal cancers represent a new nosological entity for pathogenesis, molecular mechanisms, prognostic trend and therapeutic response. Several clinical trials have shown that HPV-positive/p16-positive cancer patients have a favorable prognosis demanding for de-escalation of current therapies. Comprehensive genomic analyses allowed to identify specific genetic alterations in targetable genes envisaging novel approaches to treat different subset of HPV-related and HPV-unrelated oropharyngeal cancers. Furthermore virus associated head and neck cancers may benefit from new developed immunotherapies targeting HPV E6 and E7 oncoproteins. We reviewed recent studies on the role of HPV infection in these cancers and present our current understanding of carcinogenic mechanisms providing possible novel approaches to cancer treatment.     

Clinical and scientific impact of human papillomavirus on head and neck cancer

Head and neck cancer (HNC) arises from the skull base to the clavicles and is the fifth most common cancer in the world by incidence. Historically, in the developed world HNC was associated with tobacco use and alcohol consumption, and the combination of the two produced a synergistic increase in risk. However, beginning in 1983, investigators have found a significant and growing proportion of HNC patients with human papillomavirus-positive (HPV) tumors who neither drank nor used tobacco. Since that time, there has been increased interest in the molecular biology of HPV-positive HNC. Multiple studies now show that HPV has shifted the epidemiological landscape and prognosis of head and neck squamous cell carcinoma (HNSCC). These studies provide strong evidence for improved survival outcomes in patients with HPV-positive HNSCC compared to those with HPV-negative HNSCC. In many reports, HPV status is the strongest predictor of locoregional control, disease specific survival and overall survival. In response to these findings, there has been significant interest in the best management of HPV-positive disease. Discussions within major cooperative groups consider new trials designed to maintain the current strong survival outcomes while reducing the long-term treatment-related toxicities. This review will highlight the epidemiological, clinical and molecular discoveries surrounding HPV-related HNSCC over the recent decades and we conclude by suggesting how these findings may guide future treatment approaches.     

Clinical features and treatment strategy for HPV-related oropharyngeal cancer

Among head and neck squamous cell carcinoma (HNSCC), the incidence of oropharyngeal SCC (OPSCC) is increasing in contrast to carcinoma with origin in other subsites. Human papillomavirus (HPV) is now recognized as a significant risk factor of the carcinogenesis of OPSCC. The HPV-related OPSCC patients tend to be relatively young, less exposed to tobacco and alcohol, and have a relatively high socioeconomic status and education level, which is distinct from HPV-unrelated classical OPSCC. The neck metastases tend to be aggressive and cystic. The better response to treatment resulting in improved prognosis of HPV-related OPSCC led to reconsidering the clinical staging and treatment approaches. Clinical trials of treatment deintensification to reduce the acute and late toxicity without compromising efficacy have been conducted. This review of HPV-related OPSCC focuses on current and generally accepted facts regarding the biology, epidemiology, and therapeutic strategy of this new disease entity.     

Human papillomavirus seropositivity and risks of head and neck cancer

We examined antibody response to VLP HPV-16, HPV-16 E6 and E7 antibodies as potential seromarkers of HPV-related head and neck cancer (HNC). The study included 204 HNC cases and 326 controls evaluated for HPV presence in sera using ELISAs for anti-HPV VLP antibodies and HPV-16 E6 and/or E7 antibodies, and in tumor tissue using PCR and DNA sequencing. Anti-HPV-16 VLP was detected in 33.8% of cases and 22.4% of controls, anti-E6 in 20.6% of cases and 0.9% of controls and anti-E7 in 18.6% of cases and 0.6% of controls. HPV-16 DNA was detected in 26.1% of tumors. The adjusted risk of HNC was elevated among those seropositive for HPV-16 VLP (odds ratio (OR) = 1.7, 1.1-2.5), E6 (OR = 32.8, 9.7-110.8) or E7 (OR = 37.5, 8.7-161.2). Compared to HPV DNA-negative/seronegative cases, tumor HPV-16 cases had increased risk of detection with anti-VLP antibodies (OR = 6.8, 3.1-14.9). The odds were more pronounced among cases seropositive for E6 (OR = 69.0, 19.3-247) or E7 (OR = 50.1, 14.7-171). Antibodies against E6 or E7 were associated with risk of cancer in the oral cavity (OR = 5.1, 1.2-22.4) and oropharynx (OR = 72.8, 16.0-330), and with disease characteristics: stage, grade and nodal status. Anti-E6 and/or E7 antibodies were found in 74% of tumor HPV-16 positive cases but in only 5% of tumor HPV-negative cases (K =0.7, 0.6-0.8) suggesting good correlation between the serologic marker and HPV tumor status. Antibodies to HPV-16 E6 and/or E7 represent a more specific biomarker than anti-HPV-16 VLP of an HPV-related HNC. Because of the survival advantage of HPV-related HNC, HPV-16 E6/E7 detection may be useful in therapy targeted for HPV-related tumors.     

中国膀胱癌流行现状与趋势分析

目的分析2015年中国膀胱癌发病与死亡情况以及1998—2015年的时间变化趋势。方法收集整理全国501个登记处上报国家癌症中心的2015年肿瘤登记数据,经审核质控后统计膀胱癌性别、年龄别、地区别和合计粗发病率、粗死亡率、年龄标化率等指标,并汇总1998—2015年间中国肿瘤登记膀胱癌世标发病率和世标死亡率,采用对数线性模型拟合年度变化百分比(APC)或平均年度变化百分比(AAPC)。结果膀胱癌居中国恶性肿瘤发病谱第13位,粗发病率为5.80/10万,中标发病率为3.60/10万,世标发病率为3.57/10万;粗死亡率为2.37/10万,中标死亡率为1.31/10万,世标死亡率为1.32/10万。男性膀胱癌居恶性肿瘤发病谱第7位,发病率为女性的3.8倍,男性死亡率为女性的4.0倍。城市地区发病率为农村的1.4倍,西部地区发病率和中部地区相近,均低于东部地区,死亡率的地区分布特征与发病率相似。膀胱癌的年龄别发病率和死亡率分别在45岁和55岁组快速上升,在80~84岁组和85岁组到达高峰。时间趋势分析显示,中国膀胱癌发病率在2007年出现下降拐点,1998—2007年世标发病率呈上升趋势(APC=2.58,P<0.001),2007—2015年呈下降趋势(APC=-3.82,P<0.001)。膀胱癌世标死亡率呈持续下降趋势,速度有所减缓,1998—2003年和2003—2015年的年平均下降速度分别为3.65%(P=0.002)和1.42%(P<0.001)。结论膀胱癌是威胁中国居民健康的主要恶性肿瘤之一,存在明显的性别、地区和年龄流行差异。中国膀胱癌发病率和死亡率呈下降趋势,仍需进一步加强烟草控制,倡导中老年患者树立早诊早治意识。     

北京、上海、林州和启东地区女性乳腺癌发病及死亡的时间趋势

目的:分析1988-2007年北京、上海、林州和启东地区女性乳腺癌发病和死亡的时间趋势.方法:收集北京、上海、林州和启东4个历史资料比较完整的肿瘤登记处1988-2007年女性乳腺癌发病、死亡和相应的人口数据,进行数据汇总和时间趋势分析.结果:1988-2007年北京、上海、林州和启东地区女性乳腺癌标化发病率(采用1982年中国标准人口构成计算)年平均增长百分比分别为2.49％、2.55％、7.04％和4.16％;标化死亡率年平均增长百分比除林州增长4.10％外,北京、上海和启东地区的变化差异不显著.结论:1988-2007年,北京和上海这2个城市与林州和启东这2个农村地区相比,女性乳腺癌发病率和死亡率变化显著;4个地区的女性乳腺癌发病率均呈明显上升趋势,农村地区上升更快:林州地区女性乳腺癌死亡率有上升趋势,其他3个地区的女性乳腺癌死亡率均无明显变化.     

Time Trends of Cancer Incidence in Urban Beijing,1998-2007

Objective:To report the time trends of cancer incidence in urban Beijing from 1998 to 2007.Methods:All data were obtained from Beijing Cancer Registry from 1998-2007 in urban Beijing.Time trends of incidence rate of cancer were assessed by annual percentage change(APC) of age-standardized incidence rate(ASR) of world standard population during this 10-year period.Results:For all 156851 cancer cases combined,the incidence rate rose in both males and females,with an APC of 2.23% and 3.74%,respectively.The ...     

Trends in cause of death among patients with multiple myeloma in Puerto Rico and the United States SEER population, 1987–2013

Multiple myeloma (MM) survival has improved due to recent developments in MM treatment. As a result, other co-morbid conditions may be of increasing importance to MM patients’ long-term survival. This study examines trends in common causes of death among patients with MM in Puerto Rico, and in the US Surveillance, Epidemiology, and End Results (SEER) population. We analyzed the primary cause of death among incident MM cases recorded in the Puerto Rico Central Cancer Registry (n = 3,018) and the US SEER Program (n = 67,733) between 1987 and 2013. We calculated the cumulative incidence of death due to the eight most common causes and analyzed temporal trends in mortality rates using joinpoint regression. Analyses of SEER were also stratified by Hispanic ethnicity. MM accounted for approximately 72% of all reported deaths among persons diagnosed with MM in Puerto Rico and in SEER. In both populations, the proportion of patients who died from MM decreased with increasing time since diagnosis. Age-standardized temporal trends showed a decreased MM-specific mortality rate among US SEER (annual percent change [APC] = −5.0) and Puerto Rican (APC = −1.8) patients during the study period, and particularly after 2003 in non-Hispanic SEER patients. Temporal decline in non-MM causes of death was also observed among US SEER (APC = −2.1) and Puerto Rican (APC = −0.1) populations. MM-specific mortality decreased, yet remained the predominant cause of death for individuals diagnosed with MM over a 26-year period. The most pronounced decreases in MM-specific death occurred after 2003, which suggests a possible influence of more recently developed MM therapies.     

Metastatic squamous cell carcinoma to the brain: an unrecognized pattern of distant spread in patients with HPV-related head and neck cancer

Head and neck squamous cell carcinoma (HNSCC) is notorious for local recurrence and metastatic spread to regional lymph nodes. Distant spread is uncommon, and brain involvement is rare. Over the past decade there has been a rising incidence of HPV-related HNSCC, but it is not known if this escalation has had any impact on trends relating to brain involvement. Cases of metastatic squamous cell carcinoma (SCC) to the brain were identified from a computerized search of the surgical pathology files of The Johns Hopkins Hospital between 1985 and 2012. The medical records were reviewed to document primary site of tumor origin, treatment, and patient outcome. P16 immunohistochemistry and HPV in situ hybridization were performed on those metastases arising from the head and neck. Of the 38 metastatic SCCs, 7 (18 %) originated in the head and neck. HPV-16 was detected in 4 (57 %) of the metastatic HNSCCs. All 4 HPV-positive metastases were from oropharyngeal primaries. The time from treatment of the primary to development of the brain metastasis ranged from 19 to 57 months (mean, 45). Following aggressive treatment (surgery and radiation), two patients died of disease progression (7 and 34 months), and two are alive with recurrent brain metastases (4 and 10 months). Although HPV positivity is regarded as a favorable prognostic indicator, it does not safeguard from spread to the brain. In our experience, just over half of the HNSCCs that metastasized to the brain were HPV-related. The potential for developing a brain metastasis long after curative therapy argues for extended patient follow-up. The development of a brain metastasis is an ominous finding signaling rapid clinical deterioration.     

Human Papilloma Virus Attributable Head and Neck Cancer in the Sudan Assessed by p16INK4A Immunostaining

Background: The aim of this study was to screen for human papillomavirus (HPV) infections in head andneck squamous cell carcinomas (HNSCCs) using P16 immunostaining. Materials and Methods: A retrospectivestudy was performed on 150 samples from patients diagnosed with HNSCCs. HPV status was determined usingp16INK4A. Results: 31 of the 150 (20.7%) HNSCCs were HPV positive. Conclusions: A large proportion of HNSCCsin Sudan are associated with HPV infection. The fact that the prevalence of HPV is high among Sudanese patientswith head and neck cancers (HNC) has obvious implications for vaccine therapy.     

内蒙古2016年食管癌发病和死亡现状及2012-2016年趋势分析

目的 分析内蒙古肿瘤登记地区2016年食管癌发病和死亡现状及2012—2016年流行趋势.方法 收集2012—2016年内蒙古肿瘤登记地区食管癌数据,按照城乡、性别及年龄别分层,计算食管癌的发病(死亡)粗率、标化率、累积率、年龄别率、年度变化百分比(Annual percentage change,APC).结果 20...     

Characteristics and trends in incidence of childhood cancer in Beijing,China, 2000-2009

Objective： To investigate the characteristics and incidence trends of childhood cancer in Beijing, China, from 2000 to 2009. Methods： A total of 1,274 cases with childhood cancer in Beijing from 2000 to 2009 were included in the study. All rates were age-standardized using the direct method to the world standard population and expressed per million person-years. Incidence trends were characterized by calculating annual percent change （APC） usingJoinpoint Regression Program. Results： The crude incidence rate was 106.47 per million [age-standardized rate （ASR） 113.34] between 2000 and 2009 in Beijing with the most common diagnoses, leukemia （N=505, 39.64%, ASR 45.20）, followed by central nervous system （CNS） tumors （N=228, 17.90%, ASR 19.28） and lyrnphoma （N=91, 7.14%, ASR 6.97）. The incidence for all childhood cancers combined has increased during the study period, with an APC of 5.84% [95% confidence interval （95% CI）： 1.0-10.9] after adjusted by world population. The ASR of all combined cancers in boys showed a slight, but no significant increase, with an APC of 5.33 % （95 % CI： -0.6- 11.6）; for girls, the trends increased significantly, with an APC of 6.54% （95% CI： 1.5-11.8）. Conclusions： The incidence rate of childhood cancer in Beijing was higher than the average level of China and lower than that of western countries. The incidence trends of childhood cancer, especially leukemia among girls showed a significantly increase from 2000 to 2009. While among boys, no substantially change was seen during the observed time period. Some sex-specific trends by subcategories and trends of major cancers in different age groups by cancer site merit further investigation.