The Human Papilloma Virus (HPV) is a necessary cause of cervical cancer and is associated with other cancers including vulval, vaginal, anal, penile and oropharyngeal cancers. In this study, we evaluate the burden of HPV associated cancers using data from population based cancer registries (PBCR) in Nigeria.
We obtained data on cancers that are considered to be associated with HPV based on the IARC monograph 100b including cancers of the Cervix (C.53), Vulva (C.51), Vagina (C.52), Anus (C.21), Penis (C.60) and Oropharynx (C.01, C.09, C.10) from PBCR in Abuja (Central Nigeria), Enugu (Eastern Nigeria) and Calabar (South Eastern Nigeria). Previous literature using prevalence data and relative risks suggest that the Population Attributable Fractions (PAFs) for HPV associated cancers in developing countries were Cervical (100%) Vulval and Vaginal (40%), Anal (90%), Oropharynx (12%) in women and, Penile (40%) Anal (90%) Oropharynx (12%) in men.
Among women, the 3 PBCR reported a total of 2,986 cases of cancer between 2012 and 2014 with 493 HPV associated cancers contributing 16.5% of the total cancers. Of the 493 HPV associated cancers, 430 were cervical cancers, 27 vulva cancers, 20 anal cancers, 8 vaginal cancers and 8 oropharyngeal cancers. Of these 463 (94%) were attributable to HPV infection. The PBCR reported 1875 cancers in men between 2012 and 2014. Of these, 40 were HPV associated cancers including 22 anal cancers, 16 oropharyngeal cancers and 2 penile cancers constituting (2%) of all cancers in men. Some 23 (57.5%) of the 40 HPV associated cancers were attributable to HPV infection.
Cervical and vulva cancers were the most common HPV associated cancers among Nigerian women and anal cancers was the commonest HPV associated cancer in Nigerian men. Our findings suggest that approximately 57.5% of all HPV associated cancers in men and over 90% of all HPV associated cancers in women can be prevented if HPV infection is eliminated.