2000-2022 年丹麦与人类乳头瘤病毒相关的癌症、癌前病变和生殖器疣 - 当前疾病负担和多队列人类乳头瘤病毒疫苗接种对人口的影响。

IF 4.3 2区医学 Q1 MEDICINE, GENERAL & INTERNAL Preventive medicine Pub Date : 2024-11-10 DOI:10.1016/j.ypmed.2024.108165

Emma L. Kaderly Rasmussen , Sofie Lindquist , Louise Baandrup , Tatiana Hansen , Christian Munk , Kirsten Frederiksen , Susanne K. Kjær

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引用次数: 0

摘要

目的：我们介绍了人乳头瘤病毒（HPV）相关部位癌症和癌前病变以及生殖器疣的发病趋势，包括丹麦（一个接种多组HPV疫苗的国家）目前HPV相关疾病的负担：方法：从高质量的全国性登记（2000-2022 年）中确定病例。根据性别和日历年计算特定年龄发病率、年龄标准化发病率（ASR）和估计年百分比变化（EAPC）。目前（2020-2022 年）HPV 相关疾病的负担是以每种病变的年平均数量乘以疾病特异性 HPV 可归因部分估算得出的：宫颈癌前病变和生殖器疣的ASR在接种HPV疫苗后明显下降--生殖器疣的EAPC分别为-13.7% (-15.0;-12.4)（女性）和-8.8% (-9.4;-8.2)（男性）。男性 HPV 相关癌症部位的 ASR 持续上升（EAPC：2.8 % (2.2;3.5)），女性非宫颈 HPV 相关癌症部位的 ASR 也是如此（EAPC：2.5 % (2.0;3.0)）。不过，宫颈癌的发病率在接种 HPV 疫苗后有所下降（欧洲和中亚地区：-2.7 % (-3.8;-1.5)）。HPV相关癌症部位的特定年龄发病率在年轻女性中略有下降，在年轻男性中保持稳定，而老年男性的发病率接近甚至超过了老年女性。有关目前负担的数据显示，宫颈癌前病变和生殖器疣仍然是导致 HPV 相关疾病的主要因素，而口咽癌目前在人群中的年发病率超过了宫颈癌：丹麦的数据显示，在疫苗接种后的时代，宫颈病变和生殖器疣的发病率有所下降。尽管接种人乳头瘤病毒疫苗对人口产生了影响，但人乳头瘤病毒相关疾病仍然是一个公共卫生问题，而且越来越多地发生在男性身上。

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Human papillomavirus-associated cancers, precancers, and genital warts in Denmark, 2000–2022 – Current burden of disease and population impact of multi-cohort HPV vaccination

Objectives

We present incidence trends of cancer and precancer at human papillomavirus(HPV)-associated sites, and genital warts, including the current burden of HPV-associated disease in Denmark, a country with multi-cohort HPV vaccination.

Method

Cases were identified from high-quality nationwide registries (2000−2022). The age-specific incidence rate, age-standardized incidence rate (ASR) and estimated annual percentage change (EAPC) were calculated according to sex and calendar year. The current burden (2020−2022) of HPV-associated disease was estimated as the average annual number of each lesion multiplied by the disease-specific HPV-attributable fraction.

Results

ASRs of cervical precancer and genital warts declined markedly in the post-HPV vaccination period – for genital warts corresponding to an EAPC of −13.7 % (−15.0;−12.4)(women) and −8.8 % (−9.4;−8.2)(men), respectively. ASRs of HPV-associated cancer sites increased continuously in men (EAPC: 2.8 % (2.2;3.5)), and the same was observed for non-cervical HPV-associated cancer sites in women (EAPC: 2.5 % (2.0;3.0)). Cervical cancer, however, decreased in the post-HPV vaccination period (EAPC: −2.7 % (−3.8;−1.5)). Age-specific incidence rates of HPV-associated cancer sites decreased slightly in younger women and were stable in younger men, while incidence rates in older men approached or even surpassed that of older women. Data on the current burden showed that cervical precancer and genital warts are still the major contributors to HPV-associated disease, and oropharyngeal cancer now accounts for more annual cases on a population level than cervical cancer.

Conclusion

Danish data show decreased incidence of cervical lesions and genital warts in the post-vaccine era. Despite population impact of HPV vaccination, HPV-associated disease remains a public health issue and increasingly among men.

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来源期刊

Preventive medicine 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.70

自引率

3.90%

发文量

审稿时长

42 days

期刊介绍： Founded in 1972 by Ernst Wynder, Preventive Medicine is an international scholarly journal that provides prompt publication of original articles on the science and practice of disease prevention, health promotion, and public health policymaking. Preventive Medicine aims to reward innovation. It will favor insightful observational studies, thoughtful explorations of health data, unsuspected new angles for existing hypotheses, robust randomized controlled trials, and impartial systematic reviews. Preventive Medicine''s ultimate goal is to publish research that will have an impact on the work of practitioners of disease prevention and health promotion, as well as of related disciplines.