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  • br Other anogenital cancers and precancerous lesions

    2020-08-28


    3.4. Other anogenital cancers and precancerous lesions
    In addition to cervical cancer, HPV is responsible for a substantial number of other anogenital cancers. Globally, low age-standardized incidence rates are observed for these cancers in Korea (0.7 cases per 100,000), although data is still limited [7].
    3.4.1. Anal cancer and precancerous lesions
    Anal cancer is rare in the general ZVADFMK but is reported to be increasing in more developed regions [7]. This is probably linked to several risk factors such as changes in sexual behaviour that increases the risk of HPV exposure in the anal canal [30]. An estimated 334 new cases and 90 new deaths are diagnosed annually in Korea, with dif-ferences by sex (estimates for 2018). Crude incidence and mortality rates of anal cancer were 0.65 and 0.18 per 100,000, respectively. Age-standardized incidence and mortality rates of 0.34 and 0.08 per 100,000 were observed in Korea, compared to 0.24 and 0.10 per 100,000 in Eastern Asia (Table 3) [2].
    Regarding survival of anal cancer, data from a recent population-based study in Korea showed that overall 5-year survival increased from 38.9% (period 1993–1995) to 65.6% (period 2006–2010) [33]. The increase was consistent across histological types.
    3.4.2. Vaginal cancer and precancerous lesions
    Vaginal cancer is also a rare malignancy that shares similar risk factors with cervical cancer. It is generally accepted that both carci-nomas share the same aetiology of HPV infection although limited evidence is available. Most vaginal cancers are classified as SCC (90–95% of cases). An estimated 96 new vaginal cancer cases and 24 new deaths are diagnosed annually in Korea (estimates for 2018), with ZVADFMK crude incidence and mortality rates of 0.38 and 0.09 per 100,000 women, respectively. Age-standardized incidence and mortality rates in Korea (0.19 and 0.04 per 100,000) were similar to those in Eastern Asia (0.16 and 0.06 per 100,000) (Table 3) [2].
    At the time of the review, no large-scale population-based studies of incidence, mortality, or survival of vaginal cancer has been conducted in Korea.
    3.4.3. Vulvar cancer and precancerous lesions
    Malignancies of the vulva are also rare among women worldwide. About 60.0% of all vulvar cancer cases occur in more developed 
    countries. Regarding histology, basaloid/warty lesions generally affect young women, and are very often associated with HPV DNA detection (75–100%). Keratinizing vulvar carcinoma is the most frequent his-tology (over 60%), occurs more often in old women and is more rarely associated with HPV [34]. An estimated 143 new vulvar cancer cases and 35 new deaths are diagnosed annually in Korea (estimates for 2018), with crude incidence and mortality rates of 0.56 and 0.14 per 100,000 women, respectively. In Korea, age-standardized incidence and mortality rates were 0.28 and 0.15 per 100,000, compared to 0.31 and 0.10 per 100,000 in Eastern Asia (Table 3) [2].
    No population-based study of incidence, mortality or survival of vulvar cancer has been conducted in Korea.
    3.4.4. Penile cancer and precancerous lesions
    Malignancies of the penis are rare among men worldwide. Incidence rates are higher in less developed countries and generally affect men aged 50–70. Over 95% of invasive penile cancers are SCC (subtypes: 49% keratinizing, 17% mixed warty-basaloid, 8% verrucous, 6% warty and 4% basaloid). HPV is most commonly detected in basaloid and warty tumours [34]. In Korea, an estimated 86 new penile cancer cases and 20 new deaths are diagnosed annually (estimates for 2018), with crude incidence and mortality rates of 0.34 and 0.08 per 100,000 men, respectively. Age-standardized incidence and mortality rates in Korea (0.19 and 0.05 per 100,000, respectively) were lower than those in Eastern Asia (0.39 and 0.13 per 100,000, respectively) (Table 3) [2].
    No population-based study of incidence, mortality or survival of vulvar cancer has been conducted in Korea.
    Although smoking and alcohol consumption has been classically regarded as the major etiological factors in head and neck cancers, HPV has been recently found to cause an epidemiologically and clinically distinct form of head and neck cancer, particularly at the oropharynx, and to a weaker extent, oral cavity and larynx [34]. Moreover, the in-cidence of HPV-related head and neck cancers is sharply increasing worldwide, and is associated with lifestyle, including sexual behaviour, and is rapidly changing in Korea from a “conservative Asian” to a more open “Western” style.
    Table 4
    HPV prevalence among anogenital cancer cases and precancerous high–grade lesions in the Republic of Korea, by study.