What cancers explain the growing rural-urban gap in human papillomavirus-associated cancer incidence?

IF 3.1 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Rural Health Pub Date : 2025-01-05 DOI:10.1111/jrh.12915

Jason Semprini PhD, MPP, Whitney Zahnd PhD, Heather M. Brandt PhD

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引用次数: 0

Abstract

Purpose

Human papillomavirus (HPV) can cause cancers of the genital system, anus/rectum, and oropharynx. Prior research showed that HPV-associated cancer incidence was rising faster in nonmetro than in metro populations. Our study identified which cancers contributed to the widening disparity.

Methods

Representing ∼93% of all cancers in the United States, we analyzed data from the North American Association of Central Cancer Registries (2000-2019). Restricting the analysis to HPV-associated cancers, we compared 5-year average age-adjusted incidence rates (per 100,000 population) for nonmetropolitan (Rural-Urban Continuum Codes 4-9) and metropolitan populations, by sex and cancer site. To quantify the rural-urban gap, we calculated rate ratios and absolute differences of incidence trends.

Results

Although incidence was similar in 2000-2004 (nonmetropolitan = 9.9; metropolitan = 9.9), incidence in 2015-2019 was significantly higher in nonmetropolitan (12.3) than metropolitan (11.1) populations. The gap was widest for cervical cancers (females) in 2015-2019 (1.0 case per 100,000) but grew the most since 2000-2004 in oropharyngeal cancers among males (+1.1 cases per 100,000). The nonmetropolitan rate ratios for females (RR = 1.15, 95% C.I. = 1.13, 1.17) and males (RR = 1.07, 95% C.I. = 1.05, 1.09) in 2015-2019 were higher than the respective RRs for all other years. Since 2000, the nonmetropolitan disparity has significantly grown for anal and cervical cancers in females, and oropharyngeal cancers in both sexes.

Discussion

Although preventable, nonmetropolitan Americans have shouldered a growing burden of HPV-associated cancers. To address these cervical, anal, and oropharyngeal cancer disparities, it is imperative that HPV vaccination programs are effectively implemented at scale.

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查看原文本刊更多论文

哪些癌症可以解释人乳头瘤病毒相关癌症发病率的城乡差距？

目的：人乳头瘤病毒（HPV）可引起生殖系统、肛门/直肠和口咽部的癌症。先前的研究表明，与hpv相关的癌症发病率在非城市人口中比在城市人口中上升得更快。我们的研究确定了哪些癌症导致了差距的扩大。方法：我们分析了北美中央癌症登记协会（2000-2019）的数据，代表了美国所有癌症的93%。将分析限制在hpv相关癌症，我们比较了非大都市（城乡连续代码4-9）和大都市人口按性别和癌症部位的5年平均年龄调整发病率（每10万人）。为了量化城乡差距，我们计算了发病率比和发病率趋势的绝对差异。结果：虽然2000-2004年发病率相似(非大都市= 9.9；大都市= 9.9)，2015-2019年非大都市人群的发病率（12.3）明显高于大都市人群（11.1）。2015-2019年宫颈癌（女性）的差距最大（每10万例1.0例），但自2000-2004年以来，男性口咽癌的差距最大（每10万例+1.1例）。2015-2019年女性（RR = 1.15, 95% C.I. = 1.13, 1.17）和男性（RR = 1.07, 95% C.I. = 1.05, 1.09）的非大都市发病率比均高于其他年份。自2000年以来，女性肛门癌和宫颈癌以及男女口咽癌的非都市差异显著扩大。讨论：虽然可以预防，但非大城市的美国人已经承担了越来越多的hpv相关癌症的负担。为了解决这些宫颈癌、肛门癌和口咽癌的差异，必须大规模有效地实施HPV疫苗接种计划。

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来源期刊

Journal of Rural Health 医学-公共卫生、环境卫生与职业卫生

CiteScore

7.60

自引率

6.10%

发文量

审稿时长

>12 weeks

期刊介绍： The Journal of Rural Health, a quarterly journal published by the NRHA, offers a variety of original research relevant and important to rural health. Some examples include evaluations, case studies, and analyses related to health status and behavior, as well as to health work force, policy and access issues. Quantitative, qualitative and mixed methods studies are welcome. Highest priority is given to manuscripts that reflect scholarly quality, demonstrate methodological rigor, and emphasize practical implications. The journal also publishes articles with an international rural health perspective, commentaries, book reviews and letters.