Epidemiology of HPV-related female cancers in the Umbria region of Italy: Pre-vaccination period

We describe incidence and mortality of HPV-related female cancers in Umbria (Italy) in the pre-vaccination period (1978-2008). Joinpoint regression was applied on age-adjusted incidence and mortality rates to evaluate temporal trends. Mouth and pharynx cancers incidence and mortality trends decreased about 3% per year. For anus and anal canal cancer, incidence and mortality trends presented a non-significant decrease. For malignant neoplasm of vulva, a significant change was found in incidence trend: the annual percent change decreased from 2001 (-1.8%). Mortality trend showed a non-significant decrease. Incidence and mortality rates from vaginal cancer had in a non-significant decrease. For malignant neoplasm of cervix uteri, incidence rates showed a significant decrease by 2.1% per year. Mortality rates decreased as well though non-significantly. HPV-related cancers consistently decreased in Umbria. This trend may be a consequence of safer sexual behavior. For cervical cancer, a combination of opportunistic and programmed screening led to a much- reduced disease burden. It is expected that the implementation of vaccination in the future will lead to a further decrease of HPV-related cancer incidence and mortality.