78 per 100,000 males), 56 in the base of tongue (age-standardised

78 per 100,000 males), 56 in the base of tongue (age-standardised incidence rate 0.56 per 100,000 males) and 22 at other sites within the oropharynx (age-standardised incidence rate 0.22 per 100,000 males). Our data quantify the burden of oropharyngeal

cancer in males induced by the HPV types targeted by the current vaccines (16 and 18). The figure of 156 cancers per year 2001–2005 (age-standardised incidence rate 1.56 per 100,000 males) compares with 506 potentially preventable cervical cancers (2.42 per IWR-1 purchase 100,000 females, age-standardised incidence rate 3.5 per 100,000 females, 99% HPV-related, 70% type 16 or 18) for the same period (www.aihw.gov.au/cancer/data/datacubes/index.cfm). However, the number of cases of cervical cancer has declined steadily in developed countries, including Australia, since the introduction of organised screening that allows detection and treatment of premalignant lesions. In contrast, the incidence of HPV-related head and neck cancer is rising. Our relatively low overall HPV-positivity rate of 36% reflects the 20-year span of the study. By 2005–2006 the rate had risen to 66%, consistent with other recent studies [3], [15] and [16]. The HPV type distribution, associations with advanced stage, high-grade Vorinostat nmr tumours and predisposition for the tonsil paralleled data from other

developed countries [3], [15] and [16]. The increasing proportion of HPV-related oropharyngeal cancers in our series parallels the increasing incidence of oropharyngeal cancer in Australia (www.aihw.gov.au/cancer/data). This trend is consistent with data from other developed countries [15], [16] and [17] and has been attributed to increases in oropharyngeal HPV infection

due to increases in the practice of oral sex and in numbers of sexual partners [18]. Therefore the incidence rate of potentially preventable cases of head and neck cancer is likely to rise in the future. Smaller proportions of cancers at other sites within the head and neck region, most notably the oral cavity and larynx, are also thought to be HPV-related, although HPV-positivity rates have varied widely and the proportion of cancers caused by types other 16 and 18 seems to be higher [19] and [20]. Based on conservative HPV-positivity rates of 10% at each site, and Australian incidence data (www.aihw.gov.au/cancer/data/datacubes/index.cfm), not an average of 30 cancers elsewhere in the oral cavity per year 2001–2005 (age-standardised incidence rate 2.10 per 100,000 males) and 33 in the larynx (age-standardised incidence rate 0.1 per 100,000 males) would also have been induced by the vaccine HPV targets. Decisions on whether routine vaccination of young males is a worthwhile investment depend also on efficacy and cost-benefit analysis. The efficacy of the vaccine for prevention of cancer at non-genital sites and in prevention of cancer in males has not been proven.

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