Assessing the burden of HPV-associated cancers in Brazil: Hospitalization and mortality trends from 2011 to 2019

Human papillomavirus (HPV)-associated cancers represent a substantial public health burden. This study analyzed the national burden of hospitalization and mortality from HPV-associated cancers in Brazil between 2011 and 2019. Outcomes included average annual numbers, crude and age-standardized rates per 100,000 population, and trends estimated via joinpoint regression for cervical, vulvar, vaginal, penile, anal, and head and neck cancers (oropharynx, larynx, and oral cavity). Between 2011 and 2019, HPV-attributable cancers accounted for an average of 29,155 hospitalizations (14.3 per 100,000) and 7526 deaths (3.7 per 100,000) annually across both sexes. Among females, there were an average of 24,921 hospitalizations (24.0 per 100,000) and 6430 deaths annually, largely driven by cervical cancer. Among males, there were an estimated 4234 HPV-attributable hospitalizations and 1096 deaths per year (4.1 and 1.1 per 100,000, respectively), with penile, anal, and oropharyngeal cancers being the largest contributors. Cervical cancer accounted for 74.3% of HPV-attributable hospitalizations, followed by anal (10.4%), head and neck (9.2%), and penile cancers (3.4%). Most HPV-associated cancers showed stable hospitalization and mortality trends over time. For cervical cancer, hospitalizations rose by 3.9% annually between 2016 and 2019, while mortality rose by 0.7% annually over the entire period. Anal cancer showed significant increases in both hospitalizations (AAPC = 3.1%) and mortality (AAPC = 10.9%). These findings underscore the need for continued efforts to prevent and reduce the burden of HPV-associated cancers in Brazil, including expanded cohort vaccination, consideration of higher-valency vaccines, and improved access to early detection and timely treatment for both sexes.