Sex-based disparities in HPV-related cancer outcomes: Insights into social determinants of health.

Abstract

10529 Background: Human papillomavirus (HPV) is the most common sexually transmitted infection and a leading cause of several cancers. Research suggests that males are more likely to be infected with HPV compared with females and, as a result, have a higher incidence of HPV-related cancers, attributable to multiple social determinants of health (SDoH) factors. This study was to examine these sex-based disparities, with a focus on SDoH. Methods: The US nationally representative sample of HPV related cancer adults were analyzed from the 2011-2023 National Health and Nutrition Examination Survey (NHANES). Participants who reported having diagnosis of HPV-related cancers were included in our study. Descriptive analyses were performed, and weighted logistic regression models were used to examine associations between HPV-related cancers(Oropharyngeal Cancer, Esophageal Cancer, Prostate Cancer, Cervical Cancer, Anal Cancer, and Uterine Cancer) and key SDoH variables, including HPV vaccination, mental health issue, education level, smoking, poverty level, and health insurance coverage. Analyses were stratified by sex and adjusted for survey weights. Results are reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs). Results: A total of 692 participants (equating to 22,115,631) with HPV-related cancer were identified from NHANSE 2011-2023, with 60.3% males and 39.7% females. Compared with females, the prevalence of HPV-related cancer was significantly higher among males (34% vs. 20%). Notably, none of the males with HPV-related cancer had received HPV vaccination. Men aged 65 years and older had more than 16 times greater odds of having HPV-related cancers compared to those under 65. In contrast, older women were only 1.5 times more likely to report HPV-related cancers, highlighting a striking disparity between older males and females. Males without a high school degree have significantly lower odds of HPV-related cancer (OR: 0.38, 95% CI: 0.27–0.56). This may be attributed to a lack of HPV awareness and knowledge among males, leading to underreporting. Furthermore, non-Hispanic Black (NHB) males (OR: 1.92, 95% CI: 1.43–2.57) had greater odds of HPV-related cancer compared to non-Hispanic White (NHW) males. In comparison, NHW females had higher odds of HPV-related cancers compared with other racial and ethnic groups. These findings highlight the distinct SDoH risk factors contributing to HPV-related cancers across males and females, resulting in disparities in HPV-related cancer outcomes. Conclusions: These findings underscore the disparities faced by males regarding HPV-related cancer. Addressing these inequities requires targeted interventions focusing on men who are particularly vulnerable to HPV-related cancers, including increasing vaccination rates and reducing behavioral risks for males.