Epidemiology of HPV-related female cancers in the Umbria region of Italy: pre-vaccination period

The authors describe the incidence and mortality rates of human papillomavirus (HPV)-related female cancers in Umbria (Italy) in the pre-vaccination period from 1978-2008. Joinpoint regression was applied on age-adjusted incidence and mortality rates to evaluate temporal trends. Mouth and pharynx cancers incidence and mortality trends decreased about three percent per year. For anus and anal canal cancer, incidence and mortality trends presented a non-significant decrease. For malignant neoplasm of vulva, a significant change was found in incidence trend: the annual percentage change decreased from 2001 (- 1.8%). Mortality trend showed a non-significant decrease. Incidence and mortality rates from vaginal cancer were non-significantly decreased. For malignant neoplasm of cervix uteri, incidence rates showed a significant decrease by 2.1% per year. Mortality rates decreased as well, although non-significantly. HPV-related cancers consistently decreased in Umbria. This trend may be a consequence of safer sexual behavior. For cervical cancer, a combination of opportunistic and programmed screening led to a much-reduced disease burden. It is expected that the implementation of vaccination in the future will lead to a further decrease of HPV-related cancer incidence and mortality.