The Burden of HPV Related Cancers in Kentucky Presented on November 15, 2017 by Katie Bathje, Kentucky Cancer Consortium Many thanks to: Thomas C. Tucker, PhD, MPH Jaclyn Nee, DrPH 1
% coverage Adolescent Vaccination Coverage U.S., 2006-2016 1 st dose females: US: 65.1 KY: 54.8 1 st dose males: US: 56; KY: 41.6 Complete series females: US: 4.5; KY:.7 Complete series males: US: 7.5; KY: 28.5 MMWR Morb Mortal WklyRep 2017;66:874 882 Estimated HPV vaccination coverage with selected doses among adolescents aged 1 17 years, US and KY, National Immunization Survey Teen, United States, 70 2016 65 60 55 50 45 40 5 US KY 0 25 20 1st dose females 1st dose males Complete series females MMWR Morb Mortal WklyRep 2017;66:874 882 Complete series males 2
Impact of Human Papilloma Virus According to the CDC, in general, HPV is thought to be responsible for about 1% of cervical cancers, 75% of vaginal cancers, 6% of vulvar cancers, 6% of penile cancers, 1% of anal cancers, and 70% of oropharyngeal cancers.
Age-adjusted rates (per 100,000) KY MS WV DC AR TN LA FL OK MO SC DE NC AL GA ME IN PA OH IL OR NY IA MI MA KS RI WA CT TX NJ NH VA VT ID MT MD CA SD WY AK WI MN NE NM CO ND AZ HI UT HPV Related Cancers, Age-Adjusted Incidence Rate, by State, 200-201 0 2 4 6 8 10 12 14 16 Kentucky Retrieved from: https://www.cdc.gov/cancer/hpv/statistics/state /index.htm; Accessed November 14, 2017 8 7 6 5 4 2 1 0 Rate of HPV-Associated Cancers, US & Kentucky, 200-201 US Kentucky MMWR 2016;65(26):661 666. 4
Age adjusted Incidence rate (per 100,000) 16 Cancer Incidence Rates in Kentucky Oral Cavity and Pharynx, 2000-2014 15 14 1 12 11 10 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 5
Cervical Cancer Incidence Cervical Cancer Incidence Rates Ranked by State (2010-2014) 8th Source: CDC/USCS Website Accessed November 1, 2017 6
Age-Adjusted Rate (per 100,000) Cervix Uteri Invasive Cancer Incidence Rate 2000-2014 12 11.5 11.5 11. 11 10.5 10.4 10.1 10.5.5.1. 8.8. R² = 0.574. 8.5 8 8. 8.1 7. 7.5 7 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 7
Age-Adjusted Rate (per 100,000) Age-Adjusted Rate (per 100,000) 18 16 White vs. Black Cervix Uteri Invasive Cancer Incidence Rate 2000-2014 White Black 14 12 10 R² = 0.6888 Linear (White) Linear (Black) 8 6 R² = 0.871 4 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 14 1 12 11 10 Urban vs. Rural Cervix Uteri Invasive Cancer Incidence Rate 2000-2014 R² = 0.28 Urban Cervix Uteri Rural Cervix Uteri Linear (Urban Cervix Uteri) Linear (Rural Cervix Uteri) 8 7 R² = 0.4725 6 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 8
Age-Adjusted Rate (per 100,000) 15 14 1 12 11 10 8 7 6 Appalachia vs. Non-Appalachia Cervix Uteri Invasive Cancer Incidence Rate 2000-2014 R² = 0.4617 R² = 0.445 Appalachia Cervix Uteri Non-Appalachia Cervix Uteri Linear (Appalachia Cervix Uteri) Linear (Non- Appalachia Cervix Uteri) 5 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 Cervical Cancer Mortality
Cervical Cancer Mortality Rates Ranked by State (2010 2014) 10th Source: CDC/USCS Website Accessed November 1, 2017 10
Age-Adjusted Rate (per 100,000) Age-Adjusted Rate (per 100,000) 4.5 Overall Cervix Uteri Cancer Mortality Rates 2000-2014 4..5 2.5 2 2.8 2.4 2 2.2.1 2.7.4 2.5.5 R² = 0.0016 2.5 2.4 1.5 1 0.5 0 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 10 8 7 6 5 4 White vs. Black Cervix Uteri Cancer Mortality Rates 2000-2014 R² = 0.127 White Black Linear (White) Linear (Black) 2 R² = 0.00 1 0 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 11
Age-Adjusted Rate (per 100,000) Age-Adjusted Rate (per 100,000) 4.5 4 Urban vs. Rural Cervix Uteri Cancer Mortality Rates 2000-2014.5 R² = 0.044 2.5 2 R² = 0.08 1.5 1 0.5 Urban Rural Linear (Urban) Linear (Rural) 0 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 6 5 Appalachia vs. Non-Appalachia Cervix Uteri Cancer Appalachia Mortality Rates 2000-2014 Non-Appalachia 4 R² = 0.0024 Linear (Appalachia) Linear (Non- Appalachia) 2 R² = 0.0087 1 0 2000 2001 2002 200 2004 2005 2006 2007 2008 200 2010 2011 2012 201 2014 12
Area Development District Cervical Cancer by Area Development District in KY, 200-201 High School Education, 200-201 Pap Rate (%) 2012 Age-Adjusted Incidence Percent Rank Percent Rank Rate Rank Overall Rank Kentucky River 66.7 1 6.1 2 1.6 1 4 Cumberland Valley 68.8 2 72.1 4 11. 2 8 Barren River 7.2 8 65.1 1 11.2 12 Big Sandy 70.0 72.0 8 15 Lake Cumberland 72.5 4 7.6 6 8.5 8 18 Fivco 7.2 7 72.2 5 8.5 7 1 Buffalo Trace 74. 6 81. 12.5 5 2 Pennyrile 80.8 77.4 8 27 Gateway 74. 5 76.0 8 4.4 15 28 Purchase 8.7 11 82.1 14.7 4 2 Kipda 87.0 14 78.6 10.1 6 0 Northern Kentucky 87.1 15 74.0 7 7.6 12 4 Bluegrass 84. 1 7. 11 7.8 11 5 Lincoln Trail 8.2 10 81.6 1 7 1 6 Green River 8.8 12 8.7 15 6.5 14 41 1
% coverage Estimated HPV vaccination coverage with selected doses among adolescents aged 1 17 years, US and KY, National Immunization Survey Teen, United States, 70 2016 65 60 55 50 45 40 5 US KY 0 25 20 1st dose females 1st dose males Complete series females MMWR Morb Mortal WklyRep 2017;66:874 882 Complete series males The Hope of HPV Vaccine Uptake is rising Since its introduction 11 years ago, the vaccine: covers more strains of HPV use has been extended to males as well as females the dosage has dropped from three to two shots the cost is fully covered by private insurance and public programs The vaccine holds the promise to safely and dramatically reduce rate of and prevent many kinds of cancers that have long been responsible for the deaths of women and men across the United States and the world. 14
Thank you! Katie Bathje, Kentucky Cancer Consortium katie@kycancerc.org 15