HPV-Associated Cancers and Poverty Levels

Earlier studies have shown that being poor can affect a person's chances of getting cancer. This could happen because of less access to getting screened, diagnosed, or treated in a timely manner. One part of the study of HPV-associated cancers examined how poverty can affect these cancers. For each county in a state, the HPV-associated cancer cases were divided into three groups according to whether the people with cancer lived in a county with a high, medium, or low poverty level.

HPV-associated cancer rates and county poverty level in the United States, 1998–2003

The graph above shows age-adjusted incidence rates of HPV-associated cancers in counties with different levels of poverty. Those who live in counties with higher poverty have higher rates of cancer of the cervix, vagina, and penis. However, those who live in areas of lower poverty have higher rates of cancer of the vulva, anus (both men and women), and head and neck (women only). Men have similar rates of head and neck cancers in counties with higher and lower poverty.

HPV-Associated Cancers by Poverty Levels in Women

Cervical cancer. About 10 out of every 100,000 women who live in counties in which fewer than 10% of residents have an income below the federal poverty level are diagnosed with cervical cancer each year. The rate climbs to about 13 women per 100,000 in counties in which 10% to less than 20% of residents are below poverty level, and peaks at about 19 per women 100,000 in poorer counties. These data suggest that the cervical cancer incidence rate is higher in poorer areas.

Vulvar cancer. About 2.5 out of every 100,000 women who live in counties in which fewer than 10% of residents have an income below the federal poverty level are diagnosed with vulvar cancer each year. The rate falls slightly to about 2.4 women per 100,000 in counties in which 10% to less than 20% of residents are below poverty level, and falls to about 1.8 per women 100,000 in poorer counties. These data suggest that the vulvar cancer incidence rate is slightly lower in poorer areas.

Vaginal cancer. About 0.6 out of every 100,000 women who live in counties in which fewer than 10% of residents have an income below the federal poverty level are diagnosed with vaginal cancer each year. The rate climbs slightly to about 0.7 women per 100,000 in counties in which 10% to less than 20% of residents are below poverty level, and peaks at about 1.0 per women 100,000 in poorer counties. These data suggest that the vaginal cancer incidence rate is slightly higher in poorer areas.

Anal cancer. About 2.2 out of every 100,000 women who live in counties in which fewer than 10% of residents have an income below the federal poverty level are diagnosed with anal cancer each year. The rate is about the same, 2.2 women per 100,000 in counties in which 10% to less than 20% of residents are below poverty level, and drops to about 1.7 per women 100,000 in poorer counties. These data suggest that the anal cancer incidence rate for women is a little lower in the poorest areas.

Head and neck cancers.* About 2 out of every 100,000 women who live in counties in which fewer than 10% of residents have an income below the federal poverty level are diagnosed with head and neck cancers each year. The rate decreases slightly to about 1.8 women per 100,000 in counties in which 10% to less than 20% of residents are below poverty level, and drops slightly to about 1.6 per women 100,000 in poorer counties. These data suggest that the head and neck cancer incidence rate for women is a little lower in poorer areas.

HPV-Associated Cancers by Poverty Levels in Men

Penile cancer. About 1 out of every 100,000 men who live in counties in which fewer than 10% of residents have an income below the federal poverty level is diagnosed with penile cancer each year. The rate climbs to about 1.3 men per 100,000 in counties in which 10% to less than 20% of residents are below poverty level, and peaks at about 1.6 per 100,000 men in poorer counties. These data suggest that the penile cancer incidence rate is higher in poorer areas.

Anal cancer. About 1.5 out of every 100,000 men who live in counties in which fewer than 10% of residents have an income below the federal poverty level are diagnosed with anal cancer each year. The rate decreases slightly to about 1.3 men per 100,000 in counties in which 10% to less than 20% of residents are below poverty level, and is about 1.4 men per 100,000 in poorer counties. These data suggest that anal cancer rates in men are about the same in poorer areas as in wealthier areas.

Head and neck cancers.* About 7.5 out of every 100,000 men who live in counties in which fewer than 10% of residents have an income below the federal poverty level are diagnosed with head and neck cancer each year. The rate decreases to about 6.9 men per 100,000 in counties in which 10% to less than 20% of residents are below poverty level; the rate is 7.3 per men 100,000 in poorer counties, about the same as the least poor counties. These data suggest that head and neck cancer rates in men are about the same in poorer areas as in wealthier areas.

*Not all cancers of the head and neck were included. A smaller group of cancers in specific areas often associated with HPV were included. All cancers were limited to cell types most likely to be HPV-associated. This graph was adapted from Benard VB, Johnson CJ, Thompson TD, Roland KB, Lai SM, Cokkinides V, Tangka F, Hawkins NA, Lawson H, and Weir HK. Examining the association between socioeconomic status and potential human papillomavirus-associated cancers. Cancer 2008;113(S10):2910–2918.