Human Papillomavirus and Related Diseases Report WORLD

1 Human PapillomavirusandRelated Diseases ReportWORLDV ersion posted at on 22 October 2021- ii -Copyright and Permissions ICO/IARC Information Centre on HPV and cancer (HPV Information Centre) 2021 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 citation:Bruni L, Albero G, Serrano B, Mena M, Collado JJ, G mez D, Mu oz J, Bosch FX, de Sanjos Information Centre on HPV and cancer (HPV Information Centre). Human Papillomavirusand Related Diseases in the WORLD . Summary Report 22 October 2021. [Date Accessed]ICO/IARC HPV Information Centre- iii -AbbreviationsTable 1: AbbreviationsAbbreviationFull termHPVH uman papillomavirusHPV Information CentreICO/IARC Information Centre on HPV and CancerGWGenital wartsRRPR ecurrent respiratory papillomatosisSILS quamous intraepithelial lesionsLSILLow-grade cervical lesionsHSILHigh-grade cervical lesionsICCI nvasive cervical cancerCISC arcinoma in situCINC ervical intraepithelial neoplasiaAIN2/3 Anal intraepithelial neoplasia of grade 2 and/or 3 VIN 2/3 Vulvar intraepithelial neoplasia of grade 2 and/or 3 VaIN 2/3 Vaginal intraepithelial neoplasia of grade 2 and/or 3 PeIN 2/3 Penile intraepithelial neoplasia of grade 2 and/or 395% CI95% confidence intervalNNumber of cases testedHPV PrevHPV prevalenceASRAge-standardised rateMSMMen who have sex

4 With menNon MSMH eterosexual menSCCS quamous cell carcinomasSTIS exually transmitted infectionsHIV/AIDSH uman immunodeficiency virus/acquired immunodeficiency syndromeTSType specificEIAE nzyme immunoassayRLBMR everse line blotting methodRFLPR estriction fragment length polymorphismRHAR everse hybridisation assayRLHR everse line hybridisationLiPALine probe assaySBHS outhern blot hybridisationISHIn situ hybridisationMABAM icro array-based assayLBALine blot assayHC2 Hybrid Capture 2 SATS uspension array technologyPCRP olymerase chain reactionSPFS hort primer fragmentq-PCRQ uantitative polymerase chain reactionRLBHR everse line blot hybridisationRT-PCRReal-time polymerase chain reactionDBHDot blot hybridisationHRHigh riskDSAD irect sequence analysisMAAM icrochip array assayICO/IARC HPV Information Centre- iv -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.

5 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 the WORLD on: cervical cancer ; other anogenital cancers andhead and neck cancers; HPV- Related statistics; factors contributing to cervical cancer ; cervical cancerscreening practises; HPV vaccine introduction; and other relevant immunization indicators. The reportis intended to strengthen the guidance for health policy implementation of primary and secondary cer-vical cancer prevention strategies in the WORLD has a population of million women aged 15 years and older who are at risk of devel-oping cervical cancer .

6 Current estimates indicate that every year 569,847 women are diagnosed withcervical cancer and 311,365 die from the disease. Cervical cancer ranks* as the 4th most frequent can-cer among women in the WORLD .* Ranking of cervical cancer incidence to other cancers among all women according to highest incidence rates (ranking 1st) excluding non-melanoma skin cancer . Ranking is based on crudeincidence rates (actual number of cervical cancer cases). Ranking using age-standardized rate (ASR) may HPV Information Centre- v -Table 2: Key statistics in the WORLD and its regionsPopulationWorldHigh incomeLow and middle incomeUpper middle incomeLower middle incomeLow incomeWomen at risk for cervical cancer (Female population aged>=15 yrs) in millions2, , , , of cervical cancer and other HPV- Related cancersAnnual number of new cervical cancer cases604,12771,624532,239247,840236,8284 7,571 Annual number of cervical cancer deaths341,83129,307312,373133,105146,198 33,070 Standardized incidence rates per 100,000 population:Cervical cavity of cervical HPV infectionPrevalence (%) of HPV 16 and/or HPV 18 among womenwith.

7 Normal cervical lesions (LSIL/CIN-1) cervical lesions (HSIL/ CIN-2 / CIN-3 / CIS) see the specific sections for more HPV Information CentreCONTENTS- vi -ContentsAbbreviationsiiiExecutive summaryiv1 Introduction22 Demographic and socioeconomic factors43 Burden of HPV Related HPV Related cancers incidence .. HPV Related cancers mortality .. Cervical cancer .. Cervical cancer incidence .. Cervical cancer mortality .. Anogenital cancers other than the cervix .. Anal cancer .. Anal cancer incidence .. Anal cancer mortality .. Vulvar cancer .. Vulvar cancer incidence .. Vulvar cancer mortality .. Vaginal cancer .. Vaginal cancer incidence.

8 Vaginal cancer mortality .. Penile cancer .. Penile cancer incidence .. Penile cancer mortality .. Head and neck cancers .. Oropharyngeal cancer .. Oropharyngeal cancer incidence .. Oropharyngeal cancer mortality .. Oral cavity cancer .. Oral cavity cancer incidence .. Oral cavity cancer mortality .. Laryngeal cancer .. Laryngeal cancer incidence .. Laryngeal cancer mortality .. 784 HPV Related HPV burden in women with normal cervical cytology, cervical precancerous lesions orinvasive cervical cancer .. HPV prevalence in women with normal cervical cytology .. HPV type distribution among women with normal cervical cytology, precancerouscervical lesions and cervical cancer .

9 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 penlie lesions .. HPV burden in men .. HPV burden in the head and neck .. 219 ICO/IARC HPV Information CentreLIST OF CONTENTS- vii Burden of oral HPV infection in healthy population .. HPV burden in head and neck cancers .. 2245 Factors contributing to cervical cancer2366 Sexual behaviour and reproductive health indicators2407 HPV preventive Cervical cancer screening practices .. HPV vaccination .. HPV vaccine licensure and introduction.

10 2498 Protective factors for cervical cancer2619 References26310 Glossary302 ICO/IARC HPV Information CentreLIST OF FIGURES- viii -List of Figures1 WORLD geographical regions ..22 Population pyramid in the WORLD for 2019 ..42 Population pyramid in the WORLD for 2019 (continued) ..53 Time trends in cervical cancer incidence in the WORLD ( cancer registry data) ..63 Time trends in cervical cancer incidence in the WORLD ( cancer registry data)(continued) ..74 Comparison of HPV Related cancers incidence to other cancers in men and women of all ages in the WORLD (estimates for 2020) ..95 Comparison of HPV Related cancers incidence to other cancers among men and women 15-44 years of age in theWorld (estimates for 2020).