How Many Cancers Are Linked with HPV Each Year?

Each year, about 39,800 new cases of cancer are found in parts of the body where human papillomavirus (HPV) is often found. HPV causes about 31,500 of these cancers.

Number of HPV-Associated Cancer Cases per Year

An HPV-associated cancer is a specific cellular type of cancer that is diagnosed in a part of the body where HPV is often found. These parts of the body include the cervix, vagina, vulva, penis, anus, rectum, and oropharynx (back of the throat, including the base of the tongue and tonsils).^{1 2} These cellular types include carcinomas of the cervix and squamous cell carcinomas of the vagina, vulva, penis, anus, rectum, and oropharynx. Researchers use cancer registry data to estimate the number of HPV-associated cancers in the United States by looking at cancer in parts of the body and cancer cell types that are more likely to be caused by HPV. Cancer registries do not routinely collect data on whether HPV is in the cancer tissue. CDC studies^{3 4} have reported the number of HPV-associated cancer cases per year, and these studies have more information on how HPV-associated numbers were calculated.

Number of HPV-Attributable Cancer Cases per Year

An HPV-attributable cancer is a cancer that is probably caused by HPV. HPV causes nearly all cervical cancers and many cancers of the vagina, vulva, penis, anus, rectum, and oropharynx. A CDC study⁵ used population-based data from cancer tissue to estimate the percentage of these cancers that are probably caused by HPV. Since rectal cancer was not included in the CDC genotyping study, the percentage of anal cancer caused by HPV was used because recent studies have shown that the HPV-associated types of anal and rectal squamous cell carcinomas are similar.²

To find the number of HPV-attributable cancers, multiply the number of HPV-associated cancers by the percentage of these cancers that are probably caused by HPV. For example, about 5,229 people are diagnosed with anal cancer each year, and about 91% of anal cancers are thought to be caused by HPV. 91% of 5,229 is about 4,800, as shown in the table below.

• About 79% of anal cancers are probably caused by two types of HPV: 16 and 18.
  79% of 5,229 is about 4,200, as shown in the table below.
• About 8% of anal cancers are probably caused by HPV types 31, 33, 45, 52, and 58.
  8% of 5,229 is about 400, as shown in the table below.

Number of HPV-Associated and HPV-Attributable Cancer Cases per Year

Cancer site	Average number of cancers per year in sites where HPV is often found (HPV-associated cancers)	Percentage probably caused by any HPV typea	Number probably caused by any HPV typea	Percentage probably caused by HPV types 16/18b	Number probably caused by HPV types 16/18b	Percentage probably caused by HPV types 31/33/45/52/58c	Number probably caused by HPV types 31/33/45/52/58c
Cervix	11,693	91%	10,600	66%	7,700	15%	1,700
Vagina	819	75%	600	55%	500	18%	100
Vulva	3,671	69%	2,500	49%	1,800	14%	500
Penis	1,181	63%	700	48%	600	9%	100
Anus	5,229	91%	4,800	79%	4,200	8%	400
Female	3,416	93%	3,200	80%	2,700	11%	400
Male	1,813	89%	1,600	79%	1,400	4%	100
Rectum	772	91%	700	79%	600	8%	100
Female	528	93%	500	80%	400	11%	100
Male	244	89%	200	79%	200	4%	<100
Oropharynx	16,479	70%	11,600	60%	9,900	6%	900
Female	3,203	63%	2,000	51%	1,600	10%	300
Male	13,276	72%	9,600	63%	8,400	4%	600
TOTAL	39,844	79%	31,500	63%	25,300	10%	3,800
Female	23,330	83%	19,400	63%	14,700	13%	3,100
Male	16,514	73%	12,100	64%	10,600	4%	700

^aHPV types detected in genotyping study; most were high-risk HPV types known to cause cancer (Saraiya M et al. U.S. assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. Journal of the National Cancer Institute 2015;107:djv086).

^bHPV types 16/18 can be prevented by the bivalent, quadrivalent, and 9-valent HPV vaccines.

^cHPV types 31/33/45/52/58 can be prevented by the 9-valent HPV vaccine.

*HPV DNA was not detected in a percentage of cancers (Saraiya M et al. U.S. assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. Journal of the National Cancer Institute 2015;107:djv086).

Data are from population-based cancer registries participating in the CDC National Program of Cancer Registries and/or the NCI Surveillance, Epidemiology, and End Results Program, meeting criteria for high data quality for all years 2009 to 2013 and cover about 99% of the U.S. population.

To determine the cancers most likely to be HPV-associated, the following additional criteria were applied to the NPCR/SEER data—

• All cancers were confirmed microscopically.
• Cervical cancers were limited by histology to carcinomas only (ICD-O-3 histology codes 8010 to 8671 and 8940 to 8941).
• All other cancer sites were limited by histology to squamous cell carcinomas only (ICD-O-3 histology codes 8050 to 8084 and 8120 to 8131).
• Oropharyngeal cancers were defined as having the following ICD-O-3 site codes: 19, 24, 28, 51, 52, 90, 91, 98, 99, 100, 101, 102, 103, 104, 108, 109, 140, 142, and 148.

For more information, see Using population-based cancer registry data to assess the burden of human papillomavirus-associated cancers in the United States: Overview of methods.

References

¹International Agency for Research on Cancer. IARC monographs on the evaluation of carcinogenic risks to humans. Volume 90: Human papillomaviruses. Lyon, France: International Agency for Research on Cancer, World Health Organization; 2007.

²Shiels MS, Kreimer AR, Coghill AE, Darragh TM, Devesa SS. Anal cancer incidence in the United States, 1977–2011: distinct patterns by histology and behavior. Cancer Epidemiology, Biomarkers and Prevention 2015;24:1548–1556.

³Viens LJ, Henley SJ, Watson M, Markowitz LE, Thomas CC, Thompson TD, Razzaghi H, Saraiya M, Centers for Disease Control and Prevention (CDC). Human papillomavirus–associated cancers—United States, 2008–2012. MMWR 2016;65(26):661–666.

⁴Supplement: Assessing the Burden of HPV-Associated Cancers in the United States. Cancer 2008;113(S10):2837–3057.

⁵Saraiya M, Unger ER, Thompson TD, Lynch CF, Hernandez BY, Lyu CW, Steinau M, Watson M, Wilkinson EJ, Hopenhayn C, Copeland G, Cozen W, Peters ES, Huang Y, Saber MS, Altekruse S, Goodman MT; HPV Typing of Cancers Workgroup. US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. Journal of the National Cancer Institute 2015;107:djv086.