Accessible version: https://youtu.be/Z80AgLojsy0 - PowerPoint PPT Presentation

Accessible version: https://youtu.be/Z80AgLojsy0

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 Persistent infection with high-risk types required for progression to precancer and cancer  Peak incidence of precancers in late 20’s and of cancers in mid to late 40’s

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Average Number of New HPV-associated Cancers Overall, and by Sex, in the United States, 2005-2009 n=1003 n=3039 n=694 n=2317 n=1003 n=694 n=3039 n=1687 n=3084 Oropharynx n=9312 n=11279 n=4771 * In addition: Cervical disease and pre-invasive cancers: CIN1,2,3~ 1.4 million; AIN3~4300; VIN3~27,000,VAIN3~7600 (CDC, unpublished data)

Y axis scale is different for cervical cancer.

Males Oropharynx Anus Females * 3.9 * 2.6 White White * 1.7 3.7 * * * -1.6 5.6 Black Black * -0.3 2.5 1.0 2.1 API API -2.5 1.6 4.9 AI/AN AI/AN 0.8 0.9 Hispanic Hispanic 0.2 0.7 -6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6 7 8 9 -6 -5 -4 -3 -2 -1 0 1 2 3 4 5 6 7 8 9

HPV attributable cancers = 26,000 cancers HPV 16/18 attributable cancers= 21,000 cancers

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2006 2007 2008 2009 2010 2011 2012 October June October

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Vaccine first introduced in Australia in 2006 (dashed line) 18 Proportion with genital warts % 16 14 73% decrease 12 in genital warts 10 8 6 4 2 0 Half year Resident women

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Tdap MCV4 >1 dose HPV (girls) 3 doses HPV (girls)

Washington Montana North Minnesota Maine Dakota V e rm ont Oregon Idaho N e w H a m ps hire South Wisconsin Massachusetts Dakota New York Wyoming Michigan Connecticut Rhode Island Iowa Pennsylvania Nevada Nebraska New Jersey Ohio Illinois Indiana Delaware Maryland Utah West Colorado California Virginia Kansas Virginia Missouri Kentucky North Carolina Tennessee Oklahoma Arkansas Arizona South New Mexico Carolina Georgia Mississippi Alabama Alaska Alaska Texas Louisiana Hawaii Florida

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   ** Percent

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Response categories are not mutually exclusive

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Among girls unvaccinated for HPV, 78% had a missed opportunity

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3-dose series 1 dose 1 st dose booster Annual immunization

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   57

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        59

Percent

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          65

*p<0.05 Vaccine

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80% of cervical cancer deaths occur in developing countries Age-standardized incidence (per 100 000 women/year) 42 to 60 (12) 39 to 42 (4) 36 to 39 (4) 33 to 36 (9) 30 to 33 (6) 27 to 30 (14) 24 to 27 (9) 21 to 24 (12) 18 to 21 (12) 15 to 18 (20) 12 to 15 (16) 9 to 12 (19) 6 to 9 (23) 3 to 6 (16) 0 to 3 (6)

      No (150 countries or 77%) Yes (40 countries or 21%) Yes (Part of the country) (4 countries or 2%)

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