Human papillomavirus (HPV) is the most prevalent sexually transmitted disease and a known cause of many cancers. Previous research explored HPV-associated (HPVa) cancer differences by gender or race, but rural-urban differences in rates and trends have received little attention. This study examined rural-urban differences in rates and temporal trends for individual HPVa cancers.
The North American Association of Central Cancer Registries public use data set, representing approximately 93% of the US population, was used to calculate age-adjusted incidence rates and rate ratios (RR; 2009-2013) and overall and annual percentage changes (APC; 1995-2013) for HPVa cancers, including cervical carcinomas and squamous cell carcinomas of the vagina, vulva, penis, anus, rectum, and oropharynx. Rural-Urban Continuum Codes were dichotomized into urban (levels 1-3) and rural (4-9). RRs and APC analyses were stratified by cancer site, rurality, gender, and race/ethnicity.
Combined HPVa cancers were elevated in rural populations compared to urban (RR = 1.07; 95% CI = 1.06-1.09). Rural females had significantly higher rates of cervical, vaginal, vulvar, oropharyngeal, and anal cancer compared to their urban peers, while rural males had higher rates of penile cancer. Many disparities remained after racial/ethnic stratification (eg, white and black rural females were at increased risk of cervical carcinoma). Regarding trends, rural females and males experienced greater rate increases, or smaller rate decreases, overall and by APC, for nearly every cancer site.
Rural populations experience consistent disparities in HPVa cancers. Further research should examine contributing behavioral and epidemiological risk factors and interventions to improve HPV vaccination.
This research output has an Altmetric Attention Score of 10. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 01 March 2022.
All research outputs
#4,907,950
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Outputs from Journal of Rural Health
#236
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Outputs of similar age
#71,724
of 375,404 outputs
Outputs of similar age from Journal of Rural Health
#8
of 15 outputs
Altmetric has tracked 34,411,289 research outputs across all sources so far. Compared to these this one has done well and is in the 85th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,273 research outputs from this source. They typically receive a lot more attention than average, with a mean Attention Score of 12.9. This one has done well, scoring higher than 81% of its peers.
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