1288. Trends in Hospitalizations for Female HPV Associated Anogenital Malignancies in California by Race and Ethnicity: 1990-2007
Session: Poster Abstract Session: Viral Epidemiology
Saturday, October 22, 2011
Room: Poster Hall B1
Background:More than 90% of anal and cervical cancer and 60% of vulvar cancer are HPV associated. Nationally, cervical cancer rates continue to decrease, however, rates within the Hispanic community remain concerning. Because of the association of concurrent carriage of cervical and anal HPV oncogenic types, epidemiologic studies of HPV associated anogenital malignancies may assist with preventative efforts. 

Methods:Records of women discharged between 1990-2007 from acute care hospitalizations (ACH) with a diagnosis of anogenital malignancy were extracted from the State of California OSHPD Discharge database, we reviewed trends in female anogenital malignancies by race/ethnicity. Hospitalization data were reviewed including age, insurance type, and length of hospital stay (LOS) as well as concurrent HIV and HPV diagnosis. Data were analyzed with R-2.11.1 and Joinpoint Regression Program-3.4. 

Results:We identified 149,372 women with ACH for cervical, vulvar, and/or anal cancer. In all, 55% were White, 27%Hispanic, 8%Black, 8%Asian, and 2%other. Over 90% had cervical cancer ACH. Rare ACH (<1%) for HIV and HPV were noted. Thirty two percent White,8%Hispanic, 3%Black, and 3%Asian women had PI. From 1990-2007 vulvar and anal cancer ACH rates were higher for White women compared to other races (p < 0.001). White women had lower rates of cervical cancer ACH compared to Black and Hispanic women (p value < 0.001 and 0.02). Annual percentage change (APC) for cervical cancer was-5.46 for White vs-4.59 Black women; p value <0.04. Black women had higher rates of cervical cancer ACH than Hispanic women since 1990 (p value < 0.001), while the difference between rates has changed over time (APC-4.59 vs-3.77 for Black and Hispanic women; p value 0.02). 

Conclusion:Overall, more women with anal and vulvar cancer ACH had limited insurance vs women with cervical cancer ACH. Though our data suggest cervical cancer ACH rates were higher for Black compared to Hispanic women, California and national data demonstrate higher rates of cervical cancer diagnosis among Hispanic compared to Black women. This may indicate that more Black women are hospitalized for cervical cancer. These findings highlight the need for ongoing outpatient preventative efforts in some communities.

Subject Category: V. Virology including clinical and basic studies of viral infections, including hepatitis

Candice J. McNeil, MD, MPH, Infectious Diseases, Stanford University, Stanford, CA, Yvonne Maldonado, MD, Pediatric Infectious Diseases, Stanford University School of Medicine, Stanford, CA and Andrew Anglemyer, PhD, Pediatrics, Division of Infectious Diseases, Stanford University, Stanford, CA


C. J. McNeil, None

Y. Maldonado, None

A. Anglemyer, None

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