Trends in Incidence Rates of Anogenital Cancers in Costa Rica, 1996-2022

Human papillomavirus (HPV) is the necessary cause of cervical cancer and responsible for ~90% of anal, 78% of vaginal, 50% of penile, and 25% of vulvar cancers. In Costa Rica (CR), few studies have examined incidence trends of these cancers. We assessed age-standardized incidence rates (ASIRs) and trends of invasive anogenital cancers. Incidence data were obtained from the CR National Registry of Tumors and population estimates from the National Institute of Statistics and Census. ASIRs (1960-Segi World population) were calculated using Surveillance, Epidemiology, and End Results (SEER)*Stat, and trends and annual percent changes (APCs) using Joinpoint regression. During 1996-2022, 10,022 invasive anogenital cancer cases were included in the analysis; of which 8122 (81.0%) were cervical. Cervical cancer incidence declined significantly (APC: -3.2%, 95% confidence interval [CI]: -3.9, -2.5). Vaginal cancer showed a non-statistically significant increase (APC: 0.8%, 95% CI: -1.6, 4.1), while vulvar and penile cancers presented a non-statistically significant decrease (APC: -0.8, 95% CI: -1.9, 0.4, and -0.8, 95% CI: -2.1, 1.0, respectively). Anal cancer incidence remained stable (APC: 0.2, 95% CI: -0.9, 1.8) and was 1.4 times higher in females than males (5.3 and 3.7 per million, respectively). In males, penile cancer incidence was 3-times higher than anal cancer (10.9 vs. 3.7 per million). Non-cervical anogenital cancers were rare and showed varying trends. Cervical cancer remains a public health concern in CR, requiring stronger prevention. Research on vaccine-covered HPV genotypes and continued surveillance of anogenital cancers are needed to assess prevention impact.