Juan Carlos Orengo

Trends in the burden of HPV-associated cancers in Mexico: An analysis from 2011 to 2019

Human papillomavirus (HPV) is a major public health concern, responsible for multiple types of cancer. This study aimed to provide an overview of the burden and temporal trends of HPV-associated cancers in Mexico using national hospital discharge and mortality databases from 2011–2019, including cervical, vulvar, vaginal, penile, anal, oropharyngeal, oral cavity, and laryngeal cancers. Hospitalization and mortality rates per 100,000 population were estimated; HPV-attributable fractions applied, and age-standardized temporal trends evaluated using joinpoint regression. Cervical cancer was the leading contributor, accounting for 88.5% of hospitalizations and 90.9% of HPV-attributable deaths. Hospitalization rates for cervical cancer increased between 2011–2014 (APC = 7.5%, 95% CI: 2.3, 18.0), then declined (APC = −3.0%, 95% CI: −7.8, −0.9). Other HPV-associated cancers had lower hospitalization rates, generally below 1 per 100,000, except for penile and head and neck cancers in males. Significant increases in hospitalization rates were observed in males for anal cancer from 2011–2019 (APC = 7.1%, 95% CI: 0.8, 15.1) and oropharyngeal cancer from 2017–2019 (APC = 18.0%, 95% CI: 4.0, 31.6), while in females, for vaginal cancer from 2017–2019 (APC = 30.7%, 95% CI: 10.6, 45.3) and oral cavity cancer from 2011–2019 (APC = 8.4%, 95% CI: 2.4, 29.1). Mortality for most cancers showed decreasing or stable trends over the study period, except for vulvar cancer in females (AAPC = 1.9%, 95% CI: 0.4, 4.1) and oropharyngeal cancer in both sexes (AAPC = 4.0%, 95% CI: 0.7, 8.0). Across most cancers, males were hospitalized at older ages but died younger than females, except for anal cancer. Overall, the burden of HPV-associated cancers is substantial. While cervical cancer remains prevalent and requires continued elimination efforts, the rising burden of anal and oropharyngeal cancers among males, highlights the need to strengthen public health strategies and raise awareness of HPV’s broader impact across both sexes.

Sex disparities of vaccine-preventable cancer mortality in Latin America

This analysis estimated productivity losses and assessed sex disparities due to vaccine-preventable cancer deaths from hepatitis B virus (HBV) and human papillomavirus (HPV) in Latin America. The number of deaths and years of life lost (YLL) for 19 Latin American countries were sourced from the Institute for Health Metrics and Evaluation Global Burden of Disease (2019) for cervical, oral cavity, laryngeal, oropharyngeal, and HBV-related hepatic cancers. Attributable fractions were applied to estimate HPV-related mortality. The value of YLL (VYLL) was estimated using country-specific GDP per capita and discounted at 3%. Sensitivity and scenario analyses were conducted. In 2019, 38,786 vaccine-preventable cancer deaths resulted in over 1.1 million YLL and $5.9 billion VYLL across Latin America. Cervical cancer accounted for 81.6% of deaths and $4.9 billion in VYLL, with females representing 87.0% of the total VYLL. For males, hepatic cancer was the highest VYLL at $295 million and oral cavity the lowest ($94 million). AYLL was higher in females (30 years) than males (27 years). HBV- and HPV-related cancers impose a significant economic and mortality burden in Latin America, with marked sex disparities. Cervical cancer remains the dominant contributor among females, while males are disproportionately affected by head and neck and hepatic cancers. These findings underscore the need for sex-specific public health strategies, including expanded vaccination, improved screening, and timely treatment access across the region.