The contribution of infections to the global burden of cancer has been assessed periodically, and in the last assessment for 2008, it was estimated that 610 000 (4.8%) of all cancers worldwide were attributable to HPV (de Martel 2012). We have since updated these statistics for the year 2012 using estimates of global cancer incidence from Globocan 2012, as well as improved estimates of population attributable fractions (PAF) for infectious agents derived from a recent literature review, including a new attribution of a small proportion of oral cavity and larynx cancers to HPV.
The fractions of all cancers attributable to HPV in women and men in 2012 were compared worldwide by 8 geographical regions, and according to the Human Development Index (HDI). Separate estimates are presented for countries that have a large population or a distinct level of economic development compared to other countries in the region (China, India, Japan, South Korea, Australia and New Zealand). The PAF for HPV was estimated to be 100% for cervical cancer, 88% for anal cancer, 78% for vaginal cancer, 51% for penile cancer, 25% for vulvar cancer, 4% of oral cavity and larynx cancer and a variable proportion of oropharynx depending on region (from 15-69% depending on world region).
Of newly diagnosed cancer cases worldwide in 2012, 640,000 were estimated to be attributable to HPV, of which 570,000 were diagnosed in women, and 66,000 in men. These included 270,000, 280,000 and 90,000 cases diagnosed in age groups <50, 50 to 69 years and 70+ years, respectively. Among women, the large majority of the burden was contributed by cervical cancer (530,000), followed by Anus (18,000), Vagina (12,000), Vulva (8,500), Oropharynx (5,500), Oral cavity (3,000) and Larynx (860) cancer. For men, the contribution was from Oropharynx (24,000), Anus (17,000), Penis (13,000), Oral cavity (5,600) and Larynx (6,400). In low-HDI countries, HPV-related cancers constitute half of all infection related cancers, but the proportion of all infection-related that are caused by HPV decreases with HDI level, mainly due to the screening and treatment of cervical precancerous lesions.
In every world region, the burden of HPV-related cancer is driven by cervical cancer incidence. Differences in the burden of HPV-related cancer between the two sexes in any world region thus depends mainly on: 1) the effectiveness of cervical screening programs; and, to a lesser extent, 2) the fraction of oropharyngeal cancer attributable to HPV.
[de Martel C, et al. Lancet Oncol;13(6):607-15 (2012)].