HPV cancer burden by anatomical site, country, and region in 2022

HPV vaccination can prevent more than 90% of HPV infection-related cancers. Understanding the epidemiological burden of HPV-related cancers can better promote HPV vaccination and HPV-based screening programs. We used three databases-Global Burden of Disease 2021 (GBD2021), Global Cancer Observatory 2022 (GLOBOCAN2022), and Cancer Incidence in Five Continents Plus (CI5Plus)-to evaluate the global disease burden of cervical cancer, penile cancer, vulvar cancer, vaginal cancer, laryngeal cancer, oropharyngeal cancer, oral cancer, anal cancer, and the relative contribution of HPV infection. We used the Joinpoint regression model and piecewise linear regression to calculate the time trend and annual percentage change (APC). We combined it with the Bayesian age-period-cohort (BAPC) model to predict the disease burden in 2045. Age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) were stratified by sex, age, and geographic location. In addition, we conducted health inequality analyses across different sociodemographic index (SDI) and human development index (HDI) regions. In 2022, approximately 831,204 cancer cases (11.4% in men, 88.6% in women) and 422,935 deaths (10.4% in men, 89.6% in women) will be attributed to HPV infection, with cervical cancer accounting for the largest proportion (75.6% of cases). The country with the highest ASIR for HPV cancer was Eswatini (77.4/100,000), and the highest ASMR was Eswatini (52.1/100,000). Asia accounts for 57.8% of global HPV-related cancer cases, while Europe and Africa contribute 15.4% and 11.3%, respectively. From 1990 to 2021, the ASIR and ASMR for cervical and certain head and neck cancers showed a declining trend, with AAPCs of - 0.33% and - 1.38%. Significant regional differences in the temporal trends in ASIR for other anogenital cancers existed from 1983 to 2017. Risk factors such as smoking and unsafe sex are the main attributable factors for many cancers. The absolute number of HPV infection-related cancers will continue to rise. Given that the combined strategy of HPV vaccination and screening is cost-effective for nearly all countries, resources should be prioritized for cancer prevention programs targeting HPV infection. Especially in low-SDI areas, primary prevention targeting risk factors combined with secondary prevention can significantly reduce the overall incidence of cancer and avoid deaths due to late diagnosis.