In a new study, researchers projected that over the next 25 years, vaccination against human papillomavirus (HPV) will be associated with reduced incidence of oropharyngeal cancer (OPC) in adults from younger age groups in association with vaccination rates. However, OPC incidence is expected to continue increasing among adults aged 70 years and older who are unvaccinated. The study results were reported in JAMA Oncology.
In this US population-based study, data on HPV vaccinations were derived from the National Immunization Survey – Teen and the National Health Interview Survey. Data on OPC incidence among patients aged 34 to 83 years were collected from the Surveillance, Epidemiology, and End Results program, spanning the years 1992 through 2017. Current HPV vaccination rates were used to give a projection of expected vaccination rates through 2055, and OPC incidence was projected through 2045.
The researchers estimated that the HPV vaccination rate in adults aged 36 to 45 years will be 72.2% (95% CI, 71.4%-72.9%) by 2045. Vaccination rate among those ages 46 to 55 years is estimated to be 36.6% (95% CI, 35.2%-37.9%), but only 8.7% (95% CI, 8.1%-9.3%) among those ages 56 to 69 years. For those ages 70 to 83 years, the HPV vaccination rate is expected to be 0% (95% CI, 0%-0%).
Using current HPV vaccination patterns, OPC incidence is projected to increase from 11.9 per 100,000 persons in 2018 to 13.8 per 100,000 persons in 2045, largely tied to low vaccination rates among older adults. Incidence among persons 70 years and older is projected to increase from 16.8 to 29.0 per 100,000 during this period.
OPC incidence is projected to decrease from 1.4 to 0.8 per 100,000 persons among those ages 36 to 45 years during this period, and from 8.7 to 7.2 per 100,000 persons among those 46 to 55 years. Not much change in OPC incidence is projected for adults 56 years and older.
“Although the OPC incidence among young and middle-aged individuals will start to decrease, the modeling in this study suggests that the association of HPV vaccination with overall OPC incidence is limited in magnitude through 2045,” the researchers explained. However, after that time, a trend of reduction in OPC incidence will emerge, in conjunction with the advancing age of the vaccinated population, they concluded.
Zhang Y, Fakhry C, D’Souza G. Projected association of human papillomavirus vaccination with oropharynx cancer incidence in the US, 2020-2045. JAMA Oncol. 2021;7(10):e212907. doi:10.1001/jamaoncol.2021.2907