Distinct biomarker and behavioral profiles of human papillomavirus-related oropharynx cancer patients by age

Fakhry, Carole; Waterboer, Tim; Westra, William H.; Rooper, Lisa M.; Windon, Melina J.; Troy, Tanya; Koch, Wayne M.; Gourin, Christine G.; Bender, Noemi; Yavvari, Siddhartha; Kiess, Ana P.; Miles, Brett A.; Ryan, William R.; Ha, Patrick K.; Eisele, David W.; D’Souza, Gypsyamber

doi:10.1016/j.oraloncology.2019.104522

Cited by 21 publications

(17 citation statements)

References 25 publications

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“…10,11 Another potential component of HPV-OPC risk described in this analysis is a novel measure of sexual intensity (measured by sex-years, a calculation of the number of oral sex partners per 10 years across different ages). 18 Similar to how pack-years describes tobacco history and drink-years characterizes alcohol use, 19 the new metric of sex-years characterizes cumulative sexual exposure over time as a surrogate for potential exposure to HPV. Our data suggest that higher concentration and intensity of partner exposure is an independent predictor of HPV-OPC risk, as evidenced by an association of increased sexyears with HPV-OPC even after adjusting for number of oral sex partners.…”

Section: Discussionmentioning

confidence: 99%

“…Serum was obtained before initiation of treatment and tested for antibodies to E6 and E7 for oncogenic HPV types 16,18,31,33,35,45,52, and 58 and E1, E2, E4 for HPV types 16 and 18 at the German Cancer Research Center (Heidelberg, Germany). In brief, multiplex serology, an antibody detection method based on glutathione S-transferase capture enzymelinked immunosorbent assay was used in combination with fluorescent bead-based technology.…”

Section: Specimen Testingmentioning

confidence: 99%

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Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer

Drake

Fakhry

Windon

et al. 2021

Cancer

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BACKGROUND: Case-control studies from the early 2000s demonstrated that human papillomavirus-related oropharyngeal cancer (HPV-OPC) is a distinct entity associated with number of oral sex partners. Using contemporary data, we investigated novel risk factors (sexual debut behaviors, exposure intensity, and relationship dynamics) and serological markers on odds of HPV-OPC. METHODS: HPV-OPC patients and frequency-matched controls were enrolled in a multicenter study from 2013 to 2018. Participants completed a behavioral survey. Characteristics were compared using a chi-square test for categorical variables and a t test for continuous variables. Adjusted odds ratios (aOR) were calculated using logistic regression. RESULTS: A total of 163 HPV-OPC patients and 345 controls were included. Lifetime number of oral sex partners was associated with significantly increased odds of HPV-OPC (>10 partners: odds ratio [OR], 4.3 [95% CI, 2.8-6.7]). After adjustment for number of oral sex partners and smoking, younger age at first oral sex (<18 vs >20 years: aOR, 1.8 [95% CI, 1.1-3.2]) and oral sex intensity (>5 sex-years: aOR, 2.8 [95% CI, 1.1-7.5]) remained associated with significantly increased odds of HPV-OPC. Type of sexual partner such as older partners when a case was younger (OR, 1.7 [95% CI, 1.1-2.6]) or having a partner who had extramarital sex (OR, 1.6 [95% CI, 1.1-2.4]) was associated with HPV-OPC. Seropositivity for antibodies to HPV16 E6 (OR, 286 [95% CI, 122-670]) and any HPV16 E protein (E1, E2, E6, E7; OR, 163 [95% CI, 70-378]) was associated with increased odds of HPV-OPC. CONCLUSION: Number of oral sex partners remains a strong risk factor for HPV-OPC; however, timing and intensity of oral sex are novel independent risk factors. These behaviors suggest additional nuances of how and why some individuals develop HPV-OPC.

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Section: Discussionmentioning

confidence: 99%

Section: Specimen Testingmentioning

confidence: 99%

Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer

Drake

Fakhry

Windon

et al. 2021

Cancer

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“…Mounting evidence has shown an increase in older population in HPV‐positive NMSC [41–43]. Distribution of HPV16 among HPV‐positive oropharynx squamous cell cancer also differs by age group [44]. As for melanoma, a previous study revealed several differences exist in risk factors such as family history, UV exposure, and sunburn history between young adults and middle‐aged patients [45].…”

Section: Discussionmentioning

confidence: 99%

The Impact of Human Papillomavirus Infection on Skin Cancer: A Population-Based Cohort Study

et al. 2020

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Background This study investigated the correlation between a history of human papillomavirus (HPV) infection and skin cancer risk. Materials and Methods The study cohort comprised 26,919 patients with newly diagnosed HPV infection between 2000 and 2012; with the use of computer‐generated numbers, patients without previous HPV infection were randomly selected as the comparison cohort. The patients in the HPV infection cohort were matched to comparison individuals at a 1:4 ratio by demographic characteristics and comorbidities. All study individuals were followed up until they developed skin cancer, withdrew from the National Health Insurance program, were lost to follow‐up, or until the end of 2013. The primary outcome was subsequent skin cancer development. Cox proportional hazards regression analysis was used to analyze the risk of skin cancer with hazard ratios (HRs) and 95% confidence intervals (CIs) between the HPV and control cohort. Results The adjusted HR of skin cancer for patients with HPV relative to controls was 2.45 after adjusting sex, age and comorbidities. (95% CI, 1.44–4.18, p < .01). The subgroup analysis indicated that a patient with HPV infection had a significantly greater risk of skin cancer if they were aged >40 years. Notably, a risk of skin cancer was found in the group diagnosed with HPV within the first 5 years after the index date (adjusted HR, 3.12; with 95% CI, 1.58–5.54). Sensitivity analysis by propensity score, matching with balanced sex, age, and comorbidities, showed consistent results. Conclusion A history of HPV infection is associated with the development of subsequent skin cancer in Taiwanese subjects, and the risk wanes 5 years later. Implications for Practice In this Taiwan nationwide cohort study, there was a 2.45‐fold increased risk of developing new‐onset skin cancers for patients with incident human papillomavirus (HPV) infection, compared with the matched controls. Furthermore, the risk was noticeably significant among patients aged >40 years. A prominent risk of skin cancers was found in the group diagnosed with HPV within the first 5 years after the index date in this study. The results of this analysis may raise consensus on the effect of HPV infection on the risk of skin cancers. Clinicians are encouraged to implement prudently on the differential diagnosis of skin cancers and HPV prevention and treatment, especially in older patients.

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“…Importantly, one of the key supportive arguments for the utilization of reduced-dose radiotherapy in HPV-positive OPSCC patients is to avoid the long-term toxicities in younger, medically fit patients [18]. The lack of a significant age discrepancy between the two subgroups may be an example of the increasing prevalence of HPV-positive OPSCC's amongst older cohorts also [19].…”

Section: Discussionmentioning

confidence: 99%

Sexual Behaviour and Human Papillomavirus-Positive Oral Cavity and Oropharyngeal Cancer: An Irish Perspective

Crotty¹,

Keane²,

Cousins³

et al. 2020

Cureus

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Distinct biomarker and behavioral profiles of human papillomavirus-related oropharynx cancer patients by age

Cited by 21 publications

References 25 publications

Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer

Timing, number, and type of sexual partners associated with risk of oropharyngeal cancer

The Impact of Human Papillomavirus Infection on Skin Cancer: A Population-Based Cohort Study

Sexual Behaviour and Human Papillomavirus-Positive Oral Cavity and Oropharyngeal Cancer: An Irish Perspective

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