{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T15:02:41Z","timestamp":1790694161917,"version":"4.1.0"},"reference-count":30,"publisher":"Wiley","issue":"16","license":[{"start":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T00:00:00Z","timestamp":1724716800000},"content-version":"vor","delay-in-days":26,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000133","name":"Agency for Healthcare Research and Quality","doi-asserted-by":"publisher","award":["T32HS026133"],"award-info":[{"award-number":["T32HS026133"]}],"id":[{"id":"10.13039\/100000133","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004917","name":"Cancer Prevention and Research Institute of Texas","doi-asserted-by":"publisher","award":["RP210130"],"award-info":[{"award-number":["RP210130"]}],"id":[{"id":"10.13039\/100004917","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000069","name":"National Institute of Arthritis and Musculoskeletal and Skin Diseases","doi-asserted-by":"publisher","award":["K12AR084228\u201020S1"],"award-info":[{"award-number":["K12AR084228\u201020S1"]}],"id":[{"id":"10.13039\/100000069","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K12AR084228"],"award-info":[{"award-number":["K12AR084228"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cancer Medicine"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>While cervical cancer incidence rates (IR) in the United States have dropped in the last 20\u2009years, non\u2010cervical human papillomavirus (HPV) associated cancers increased. Many people in Texas (TX) live in medically underserved areas and have higher risk of developing HPV\u2010associated cancers. Since previous studies of these regions focused on cervical cancer, we included other HPV\u2010associated cancers in our analysis of IR in East TX and the TX\u2010Mexico Border compared to other TX regions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Cancer data from 2006 to 2019 were obtained from the TX Cancer Registry. Cases of HPV\u2010associated cervical, vaginal, vulvar, penile, anal, and oropharyngeal cancers and corresponding patient\u2010level demographic data were included. We calculated IR per 100,000 and drew heat maps to visualize cancer IR by county. To control potential confounders, we added county\u2010level risk factors: rates for smoking, excessive drinking, obesity, STIs, primary care provider availability and dentist availability, from the County Health Rankings and Roadmaps program. We reported IRs by region and time and estimated unadjusted and adjusted risk ratio (RR) for association of each type of cancer and region. Lastly, we created adjusted models for each cancer by period to see time trends of regional differences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Risk of anal, cervical, and oropharyngeal cancer was lower at parts of the Border than in the rest of TX in the adjusted model. We also observed increasing anal and oropharyngeal cancer risk and decreasing cervical and vaginal cancer risk over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Patient sociodemographics, behavioral risk factors, and access to care may contribute to some observed differences in cancer IR across regions. This indicates that targeted prevention efforts towards these regions, especially in low socioeconomic status communities, may benefit future generations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/cam4.70133","type":"journal-article","created":{"date-parts":[[2024,8,27]],"date-time":"2024-08-27T12:40:21Z","timestamp":1724762421000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trends in HPV\u2010associated cancer incidence in Texas medically underserved regions"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8444-0529","authenticated-orcid":false,"given":"Thao N.","family":"Hoang","sequence":"first","affiliation":[{"name":"Institute for Translational Sciences University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5007-1080","authenticated-orcid":false,"given":"Abbey B.","family":"Berenson","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research in Women's Health University of Texas Medical Branch  Galveston Texas USA"},{"name":"Department of Obstetrics and Gynecology The University of Texas Medical Branch at Galveston  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Shan","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3729-2724","authenticated-orcid":false,"given":"Fangjian","family":"Guo","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research in Women's Health University of Texas Medical Branch  Galveston Texas USA"},{"name":"Department of Obstetrics and Gynecology The University of Texas Medical Branch at Galveston  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor","family":"Adekanmbi","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research in Women's Health University of Texas Medical Branch  Galveston Texas USA"},{"name":"Department of Obstetrics and Gynecology The University of Texas Medical Branch at Galveston  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine","family":"Hsu","sequence":"additional","affiliation":[{"name":"Center for Interdisciplinary Research in Women's Health University of Texas Medical Branch  Galveston Texas USA"},{"name":"Department of Obstetrics and Gynecology The University of Texas Medical Branch at Galveston  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong\u2010Fang","family":"Kuo","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science University of Texas Medical Branch  Galveston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,8,27]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/OLQ.0b013e318286bb53"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/rmv.1822"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23758"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-12-1406"},{"key":"e_1_2_10_6_1","unstructured":"Key Statistics for Anal Cancer.https:\/\/www.cancer.org\/cancer\/anal\u2010cancer\/about\/what\u2010is\u2010key\u2010statistics.html."},{"key":"e_1_2_10_7_1","unstructured":"Oral Cavity & Oropharyngeal Cancer Key Statistics2021.https:\/\/www.cancer.org\/cancer\/oral\u2010cavity\u2010and\u2010oropharyngeal\u2010cancer\/about\/key\u2010statistics.html."},{"key":"e_1_2_10_8_1","unstructured":"Vulvar cancer\u2014Symptoms and causes. 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