Human Papillomavirus and Related Diseases …

1 Human PapillomavirusandRelated Diseases ReportINDIAV ersion posted at on 17 June 2019- ii -Copyright and Permissions ICO/IARC Information Centre on HPV and Cancer (HPV Information Centre) 2019 All rights reserved. HPV Information Centre publications can be obtained from the HPV Informa-tion Centre Secretariat, Institut Catal d Oncologia, Avda. Gran Via de l Hospitalet, 199-203 08908L Hospitalet del Llobregat (Barcelona) Spain. E-mail: Requests for per-mission to reproduce or translate HPV Information Centre publications - whether for sale or for non-commercial distribution- should be addressed to the HPV Information Centre Secretariat, at the designations employed and the presentation of the material in this publication do not imply theexpression of any opinion whatsoever on the part the HPV Information Centre concerning the legalstatus of any country, territory, city or area or of its authorities, or concerning the delimitation of itsfrontiers or boundaries.

2 Dotted lines on maps represent approximate border lines for which there maynot yet be full agreement. The mention of specific companies or of certain manufacturers products doesnot imply that they are endorsed or recommended the HPV Information Centre in preference to othersof a similar nature that are not mentioned. Errors and omissions excepted, the names of proprietaryproducts are distinguished by initial capital letters. All reasonable precautions have been taken by theHPV Information Centre to verify the information contained in this publication. However, the publishedmaterial is being distributed without warranty of any kind, either expressed or implied. The respon-sibility for the interpretation and use of the material lies with the reader.

3 In no event shall the HPVI nformation Centre be liable for damages arising from its development of this report has been supported by grants from the European Comission (7th Frame-work Programme grant HEALTH-F3-2010-242061, HEALTH-F2-2011-282562, HPV AHEAD).Recommended citation:Bruni L, Albero G, Serrano B, Mena M, G mez D, Mu oz J, Bosch FX, de Sanjos S. ICO/IARCI nformation Centre on HPV and Cancer (HPV Information Centre). Human Papillomavirus and RelatedDiseases in India. Summary report 17 June 2019. [Date Accessed]ICO/IARC HPV Information Centre- iii -Executive summaryHuman Papillomavirus (HPV) infection is now a well-established cause of cervical cancer and there isgrowing evidence of HPV being a relevant factor in other anogenital cancers (anus, vulva, vagina andpenis) as well as head and neck cancers.

4 HPV types 16 and 18 are responsible for about 70% of all cer-vical cancer cases worldwide. HPV vaccines that prevent HPV 16 and 18 infections are now availableand have the potential to reduce the incidence of cervical and other anogenital report provides key information for India on: cervical cancer; other anogenital cancers and headand neck cancers; HPV- Related statistics; factors contributing to cervical cancer; cervical cancer screen-ing practices; HPV vaccine introduction; and other relevant immunisation indicators. The report isintended to strengthen the guidance for health policy implementation of primary and secondary cervi-cal cancer prevention strategies in the 1: Key StatisticsPopulationWomen at risk for cervical cancer (Female population aged >=15 years) millionBurden of cervical cancer and other HPV- Related cancersAnnual number of cervical cancer cases96,922 Annual number of cervical cancer deaths60,078 Crude incidence rates per 100,000 and year:MaleFemaleCervical cancer cancer cancer cancer of cervical HPV infectionPrevalence (%) of HPV 16 and/or HPV 18 among women with.

5 Normal cervical lesions (LSIL/CIN-1) cervical lesions (HSIL/CIN-2/CIN-3/CIS) factors contributing to cervical cancerSmoking prevalence (%), [ ]Total fertility rate (live births per women) contraceptive use (%) among prevalence (%), adults (15-49 years)-Sexual behaviourPercentage of 15-year-old who have had sexual intercourse (men/women) / 8 Range of median age at first sexual intercourse (men/women)- / screening practices and recommendationsCervical cancer screening cov-erage, % (age and screening in-terval, reference) (All women aged 25-64 screened every 3y, WHS 2003 India)Screening ages (years)35-64 (cytology)Screening interval (years) orfrequency of screens3 yearsHPV vaccineHPV vaccine introductionHPV vaccination programmePilotDate of HPV vaccination routine immunization programme start- Please see the specific sections for more HPV Information CentreCONTENTS- iv -ContentsExecutive summaryiii1 Introduction22 Demographic and socioeconomic factors43 Burden of HPV Related Cervical cancer.

6 Cervical cancer incidence in India .. Cervical cancer incidence by histology in India .. Cervical cancer incidence in India across Southern Asia .. Cervical cancer mortality in India .. Cervical cancer mortality in India across Southern Asia .. Cervical cancer incidence and mortality comparison, Premature deaths and dis-ability in India .. Anogenital cancers other than the cervix .. Anal cancer .. Vulvar cancer .. Vaginal cancer .. Penile cancer .. Head and neck cancers .. Oropharyngeal cancer .. 314 HPV Related HPV burden in women with normal cervical cytology, cervical precancerous lesions orinvasive cervical cancer.

7 HPV prevalence in women with normal cervical cytology .. HPV type distribution among women with normal cervical cytology, precancerouscervical lesions and cervical cancer .. HPV type distribution among HIV+ women with normal cervical cytology .. Terminology .. HPV burden in anogenital cancers other than cervix .. Anal cancer and precancerous anal lesions .. Vulvar cancer and precancerous vulvar lesions .. Vaginal cancer and precancerous vaginal lesions .. Penile cancer and precancerous penile lesions .. HPV burden in men .. HPV burden in the head and neck .. Burden of oral HPV infection in healthy population .. HPV burden in head and neck cancers.

8 595 Factors contributing to cervical cancer626 Sexual and reproductive health behaviour indicators647 HPV preventive Cervical cancer screening practices .. HPV vaccination .. 678 Protective factors for cervical cancer67 ICO/IARC HPV Information CentreLIST OF CONTENTS- v -9 Indicators Related to immunisation practices other than HPV Immunisation schedule .. Immunisation coverage estimates .. 6910 Glossary70 ICO/IARC HPV Information CentreLIST OF FIGURES- vi -List of Figures1 India and Southern Asia ..22 Population pyramid of India for 2017 ..43 Population trends in four selected age groups in India ..44 HPV- Related cancer incidence in India (estimates for 2012) ..65 Comparison of cervical cancer incidence to other cancers in women of all ages in India (estimates for 2018).

9 86 Comparison of age-specific cervical cancer to age-specific incidence of other cancers among women 15-44 yearsof age in India (estimates for 2018) ..97 Annual number of cases and age-specific incidence rates of cervical cancer in India (estimates for 2018) ..108 Time trends in cervical cancer incidence in India (cancer registry data) ..129 Age-standardised incidence rates of cervical cancer of India (estimates for 2018) ..1310 Annual number of new cases of cervical cancer by age group in India (estimates for 2018) ..1411 Comparison of cervical cancer mortality to other cancers in women of all ages in India (estimates for 2018) ..1612 Comparison of age-specific mortality rates of cervical cancer to other cancers among women 15-44 years of agein India (estimates for 2018).

10 1713 Annual number of deaths and age-specific mortality rates of cervical cancer in India (estimates for 2018) ..1814 Comparison of age-standardised cervical cancer mortality rates in India and countries within the region (esti-mates for 2018) ..1915 Annual deaths number of cervical cancer by age group in India (estimates for 2018) ..2016 Comparison of age-specific cervical cancer incidence and mortality rates in India (estimates for 2018) ..2117 Comparison of annual premature deaths and disability from cervical cancer in India to other cancers amongwomen (estimates for 2008) ..2218 Time trends in anal cancer incidence in India (cancer registry data) ..2419 Time trends in vulvar cancer incidence in India (cancer registry data).