Global burden of HPV-related cancers in men: A systematic literature review.
e13108 Background: Human papillomavirus (HPV) causes about 5% of all cancer cases worldwide. Global male-specific incidence of HPV-related cancers, including anal (AC), penile (PC) and head and neck (HNC) cancer, is largely unknown. This study aims to summarize global incidence and HPV prevalence of these cancers in men. Methods: The systematic literature review was conducted following PRISMA guidelines. MEDLINE and EMBASE were searched for studies published in English between Jan 2008-Mar 2018 containing male-specific AC/PC/HNC incidence data, or HPV prevalence in AC/PC/HNC adult patients. Results: Fifty-six studies reported AC incidence in men between 1962-2014. The rate ranged between 0-1.5/100,000 persons in the general population. Globally, AC incidence increased over time. In the US, AC incidence in HIV-positive men increased from 10.5 to 20.7/100,000 person-years (PYs) from 1980-1989 to 1990-1995, and from 47 to 270/100,000 PYs between 1984 and 2013 in HIV-positive men who have sex with men (MSM). Prevalence of any HPV among men with AC ranged between 20-96%, HPV-16 and -18 being the most prevalent (14-100% vs 8-24%). PC incidence among men was reported in 14 studies between 1962-2015. The rate ranged between 0-10.2/100,000 persons (0-12.8/100,000 PY), with higher incidence rates in older men. Prevalence of any HPV among men with PC ranged between 6.3-100%, HPV-11 and -16 being the most prevalent (0.7-80% vs 18.1-79.2%). HNC incidence among men was reported in 66 studies between 1973-2014. Global cancer registry data reported a range of HNC incidence from 1.4-42.2/100,000, declining over time depending on the geographical location. The corresponding incidence range for oropharyngeal cancer (OPC) was 0.4-17.8/100,000, with higher incidence rates for men aged 55 and above and a rapid increase during the past decade in well-developed regions. Prevalence of any HPV ranged between 0-93.8%, HPV-16 and -18 being the most prevalent (1.2-86% vs 2.5-46.9%). Conclusions: This review demonstrates the existing burden of HPV-related cancers globally. Overall, the incidence of HPV-related AC and OPC appears to have increased among men between 1962 and 2015, highlighting a growing unmet medical need and the importance of preventing HPV infection.