Introduction Alcohol and tobacco are the most important risk factors for head and neck cancers (HNC). However, in some countries, it has been observed an increase in incidence rates, particularly among young people and among non-drinkers and non-smokers. These trends have increased the debate about the role of human papillomavirus (HPV) and several studies suggest that this infection may play a causative role in oropharyngeal tumours. This study aims to assess the magnitude of cancers potentially related to HPV in Brazil.
Methods Time series study including deaths due to HNC registered in Brazil, from 1980 to 2007. Age-adjusted mortality rates are described for 100 000 people, according to tumour site (HPV-related or non-HPV related) and sex. Annual percentage change (APC) was calculated through Joinpoint modeling method, using the calendar year as regressor variable.
Results We observed a statistically significant increasing trends in mortality rates due to HPV-related HNC among males in the periods of 1980–1994 (APC=2.4, 95% CI 1.0 to 3.8) and 1997–2005 (APC=4.0, 95% CI 0.8 to 7.4), followed by a decrease in 2005–2007 (APC=−27.2, 95% CI −44.6 to −4.4), while for females a significant increase in rates was observed between 1980 and 1998 (APC=7.6, 95% CI 0.3 to 15.4), followed by a decreasing trend in the period 1998–2007 (APC=−2.7, 95% CI −4.2 to −1.3). Regarding non-HPV related HNC, significant changes were only observed for females (1980–2007, APC=−2.1, 95% CI −2.8 to −1.4).
Conclusion Important decreases in HPV-related HNC mortality were recently observed in Brazil, particularly among females. These results can suggest that these trends reflects better prognosis related to HPV-positive HNC.
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