Sameer V Gopalani

Population-level incidence of human papillomavirus–positive oropharyngeal, cervical, and anal cancers, by smoking status

Abstract We estimated the population-level incidence of human papillomavirus (HPV)–positive oropharyngeal, cervical, and anal cancers by smoking status. We combined HPV DNA genotyping data from the Centers for Disease Control and Prevention’s Cancer Registry Sentinel Surveillance System with data from the Kentucky Cancer Registry and Behavioral Risk Factor Surveillance System across smoking status. During 2004-2005 and 2014-2015 in Kentucky, most cases of oropharyngeal (63.3%), anal (59.7%), and cervical (54.9%) cancer were among individuals who ever smoked. The population-level incidence rate was higher among individuals who ever smoked than among those who never smoked for HPV-positive oropharyngeal (7.8 vs 2.1; adjusted incidence rate ratio = 2.6), cervical (13.7 vs 6.8; adjusted incidence rate ratio = 2.0), and anal (3.9 vs 1.6; adjusted incidence rate ratio = 2.5) cancers. These findings indicate that smoking is associated with increased risk of HPV-positive oropharyngeal, cervical, and anal cancers, and the population-level burden of these cancers is higher among individuals who ever smoked.

Breast, cervical, and colorectal cancer screening prevalence in the US-Affiliated Pacific Islands

Breast, cervical, and colorectal cancer screening are recommended and can reduce mortality from these cancers, yet information on screening prevalence in the US-Affiliated Pacific Islands (USAPI) is limited. We analyzed data from population-based cross-sectional surveys undertaken at different time points from 2016 to 2019 in American Samoa, the Commonwealth of the Northern Mariana Islands, the Republic of Palau, the Republic of the Marshall Islands, and the Federated States of Micronesia states of Pohnpei and Kosrae. We estimated the age-standardized percentage of never screened and up-to-date screening for breast, cervical, and colorectal cancer among eligible adults by select sociodemographic and health characteristics. In the USAPI overall, 20.6 % (95 % confidence interval [CI]: 18.6, 22.8) of participants were up-to-date with breast cancer screening, 38.6 % (95 % CI: 37.1, 40.2) with cervical cancer screening, and 15.1 % (95 % CI: 13.8, 16.4) with colorectal cancer screening. Screening in the USAPI overall was lower for all three cancers among participants who reported having a high school education or less compared to those with more than a high school education. Cervical cancer screening was lower among participants with diabetes compared to those without diabetes, and colorectal cancer screening was lower among participants who reported tobacco use than among those without tobacco use. Cancer screening was suboptimal across all three cancer types in the USAPI. Developing, implementing, or expanding culturally tailored and effective cancer screening strategies may address barriers to screening and improve access and utilization.