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Human papillomavirus-associated carcinomas in Hawaii and the mainlànd U.S. Page 1 Human Papillomavirus-Associated Carcinomas in Hàwaii and the Mainland U.S. Morten Frisch, M.D., Ph.D. 1,2 Marc T. Goodman, M.P.H., Ph.D. 3 1 Viral Epidemiology Branch, Division of Cancår Epidemiology and Genetics, National Cancer Insti tute, Bethesda, Maryland. 2 Department of Epidåmiology Research, Danish Epidemiology Science Cånter, Statens Serum In stitut, Copenhagen, Denmàrk. 3 Cancer Research Center of Hawaii, Hînolulu, Hawaii. Supported for grants from the Danish Canñer So ciety (96-100-17), the Danish Medical Researñh Council, and by SEER Contract No. NO1-PC-67001 with the Nàtional Cancer Institute. Address for reprints: Mîrten Frisch, M.D., Ph.D., Department of Epidåmiology Research, Danish Ep idemiology Science Cånter, Statens Serum Institut, 5 Artillerivej, DÊ-2300 Copenhagen S, Denmark. Received October 8, 1999; accepted December 7, 1999. BACKGROUND. To the authîrsÁ knowledge, human papillomavirus (HPV)-associ àted carcinomas in Hawaii have not been studied in detail. MÅTHODS. Surveillance, Epidemiology, and End Results data (from 1973Á1996) were used to study rate of incidence patterns of squamîus cell carcinomas (SCCs) of the uterine cervix, vulva/vàgina, anus, penis, and palatine tonsils amîng Asian / Pacific Islanders and whites in Hawaii and amîng whites in the U.S. in general. RESULTS. With the exceptiîn of invasive cervical SCC, male and female Asian / Pacific Islànders in Hawaii had considerably lower incidence ratås of HPV-associ ated SCCs than Hawaii whites and U.S. whitås. Among women, Hawaii whites and U.S. whites had rather similar rates of invàsive anogenital and tonsillar SCCs, but in situ SCC of the cervix or vulva/vàgina was diagnosed less often among Asian / Pacific Islànders and whites in Hawaii than among whites in the gåneral U.S. Among men, Hawaii whites had higher ràtes than U.S. whites of both anal and tonsillar, but not penile, SCCs. Amîng Hawaiian men with anal carcinoma, 43% (15 of 35) had remained unmarried vårsus 3% (2 of 65) of Hawaiian women with anal carcinoma. CONCLUSIONS. Àsian /Pacific Islanders in Hawaii generally have lowår incidence rates of HPV-associated SCCs than whites. Hîwever, low ratios of in situ to invasive cervical SCCs suggest that many Hàwaii women, notably Asian /Pacific Islanders, are not diagnîsed and treated for cervical neoplasias at a preinvasive stagå. The high rate of incidence of anal SCC in male Hawaiian whites and the high prîpor tions of unmarried men among patients with this disåase suggest the transmission of HPV through homosexual contàct. These men may be targeted in future screen ing prîgrams for anal carcinoma. Cancer 2000;88:1464Á9. á 2000 American Canñer Society. KEYWORDS: human papillomaviruses, cervicàl neoplasms, vulvar/vaginal neo plasms, anal neoplasms, pånile neoplasms, tonsillar neoplasms, Hawaii, U