Beyond Women's Health: Long-Term Human Papillomavirus-Related Cancer Trends in Norway

Understanding the total burden of human papillomavirus (HPV)-related cancers is crucial for improving prevention strategies. While organized cervical cancer (CC) screening has been implemented for many years, other HPV-related cancers lacked screening programs. Primary prevention through HPV vaccination has been implemented through national programs, initially for girls and later for boys. To analyze changes in HPV-attributable cancer incidence for both men and women, we used data from the Cancer Registry of Norway (CRN).

This was an observational population-based study using high-quality data from the CRN. The proportion of cancers at each site attributed to HPV was calculated based on existing literature. We estimated HPV cancer incidence rates from 1990 to 2023 and forecasted incidences until 2038 for cervical squamous cell carcinoma (SCC) and adenocarcinoma, along with other HPV-related SCCs.

Among men, HPV-attributable cancer incidence was rising, with male oropharyngeal SCC showing the fastest increase (annual percentage change [APC], 4.5; P < .01). Overall, the incidence of HPV-attributable cancers not prevented by screening steadily increased (APC, 2.8; P < .01), surpassing CC incidence and projected to continue rising until 2038. In women, CC remains the most common HPV cancer. However, after an increasing trend since 2004, cervical SCC incidence rates decreased 6% annually from 2018 to 2023 (95% confidence interval [CI], -9.9 to -1.9; P < .01).

The burden of HPV-related cancers beyond CC is increasing in Norway, whereas CC incidence is declining. Addressing the rising total burden of HPV-attributable cancers requires additional preventive measures.