HPV-Related Oropharynx Cancer in the United Kingdom: An Evolution in the Understanding of Disease Etiology

Schache, Andrew; Powell, Ned; Cuschieri, Kate; Robinson, Max; Leary, Sam D; Mehanna, Hisham; Rapozo, Davy; Long, Anna; Cubie, Heather; Junor, Elizabeth; Monaghan, Hannah; Harrington, Kevin; Nutting, Christopher M.; Schick, Ulrike; Lau, Andy S.; Upile, Navdeep; Sheard, Jon; Brougham, Kath; West, Catharine M L; Oguejiofor, Kenneth; Thomas, Steve; Ness, Andy R; Pring, Miranda; Thomas, Gareth J.; King, Emma V.; McCance, Dennis J.; James, Jacqueline; Moran, Michael; Sloan, P; Shaw, Richard; Evans, Mererid; Jones, Terry M.

doi:10.1158/0008-5472.can-16-0633

Cited by 138 publications

(119 citation statements)

References 28 publications

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“…Moreover, the total number of OPSCCs patients also increased from 2000 to 2015. 32 As the number of female OPSCC patients per year was limited, we had to stratify the patients in 5-year intervals; but a significant increase in HPV-attributable OPSCC in female patients could be observed from 2000 till 2015. 13 The increase in HPV-positive OPSCC as well as the general increase in OPSCC corresponds with published data in the United States and other European countries.…”

Section: Discussionmentioning

confidence: 99%

Epidemiologic associations of HPV‐positive oropharyngeal cancer and (pre)cancerous cervical lesions

Rietbergen

Bokhoven

Lissenberg‐Witte

et al. 2018

Intl Journal of Cancer

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Human papillomavirus (HPV)-induced oropharyngeal squamous cell carcinoma (OPSCC) remains increasing worldwide. We aimed to investigate if the HPV-prevalence of OPSCC in the Netherlands is rising as well, also in female patients. In addition, we evaluated the association between HPV-positive OPSCC and suspicious Pap results of the cervix in these female patients. Patients with OPSCC treated in the period 2000-2015 at the VU University Medical Center Amsterdam, were included (n = 926). The presence of an oncogenic HPV infection was determined by p16-immunostaining, followed by a high-risk HPV general primer 5+/6+ DNA PCR on the p16-immunopositive cases. A review of pathology reports in all female patients (n = 305) was undertaken to identify cytological signs of HPV-related (pre)cancer of the cervix. In total 281 of 926 (30.3%) OPSCCs were HPV-positive. Moreover, a significant increase in the prevalence of HPV-positive OPSCCs was observed from 14.0% in 2000 to 48.1% in 2015 (p < 0.001). Among the female patients with an HPV-positive OPSSC (n = 70), the results of cervical smears were available in 56 of 70 patients (80.0%). Of the female patients with HPV-positive OPSCC, 9 of 56 (16.1%) patients had a vaginal cuff Papanicolaou (Pap) test ≥3b in their medical history compared to 7 of 168 (4.2%) in the HPV-negative group (p = 0.003). In conclusion, a continuous increase in the HPV-attributable fraction of OPSCC was demonstrated in the period 2000-2015 in the Amsterdam region. HPV-positive OPSCC has a significant association with a history of suspicious Pap results of the cervix in female patients.

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Section: Discussionmentioning

confidence: 99%

Epidemiologic associations of HPV‐positive oropharyngeal cancer and (pre)cancerous cervical lesions

Rietbergen

Bokhoven

Lissenberg‐Witte

et al. 2018

Intl Journal of Cancer

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“…All are consistent in that in addition to the “classical tonsillar carcinoma” ascribed to heavy alcohol use and smoking, the incidence of HPV-associated tonsillar and base of the tongue carcinomas is alarmingly increasing since the late 1960s. However, recent evidence from the UK indicates that the proportion of OPSCC testing HPV positive between 2002 and 2011 has remained stable (around 50% HPV positive), whereas the incidence of both HPV-negative and HPV-positive OPSCCs is increasing among men but not women [52]. It is well established by now that HPV-positive OPSCCs have a better prognosis.…”

Section: Hpv In Hnsccmentioning

confidence: 99%

HPV in Head and Neck Carcinomas: Different HPV Profiles in Oropharyngeal Carcinomas – Why?

Syrjänen

2019

Acta Cytologica

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Background: The association of human papillomavirus (HPV) with head and neck squamous cell carcinoma (HNSCC) was first described in 1982–1983 by the authors of this review. Prompted by this discovery 35 years ago, an entirely new field of HPV research has emerged, resulting in a paradigm shift from smoking and alcohol as the only etiological factors to confirmation of HNSCC as an important group of HPV-related human malignancies. Summary: In this review, the authors first describe the scope (i.e., HNSCC) by the anatomic sites of the tumors. Their important site-specific differences in epidemiology are emphasized, and the misconceptions caused by the adopted practice of pooling all tumors from these divergent anatomic sites as a single entity (HNSCC) are pinpointed. The convincing evidence of the established risk factors (smoking and alcohol) is briefly addressed, before entering in the discussion on the causal role of HPV in HNSCC pathogenesis. The global HPV prevalence in different subsets of HNSCC is summarized using the data extracted from all meta-analyses published since 2010. Of all HNSCC subsets, oropharyngeal SCC has an HPV profile distinct form all the other subsets, and the possible mechanisms explaining this intimate association with HPV are discussed. Key Messages: Recent global trends show a constant increase in HNSCC rates particularly among younger age groups. The evidence on cigarette smoking and alcohol consumption as the prime risk factors of HNSCC is overwhelming. During the past 35 years, however, increasing evidence has accumulated implicating an important causal role of HPV in HNSCC. These data have important clinical implications, HPV detection and tailored treatment strategies for HPV-positive HNSCCs currently being an integral part of the oncological management practices of HNSCC.

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“…Currently, good epidemiological data exist for increased numbers of HPV-related oropharyngeal cancer around the world [2,3] (Table 1). While there has been a continued increase in the prevalence of HPV oropharyngeal cancer over time a recent UK study suggests this has plateaued (Table 2).…”

Section: Epidemiology Of Oropharyngeal Cancermentioning

confidence: 99%

Transoral Robotic Surgery for Oropharyngeal Cancer

Paleri¹,

Fox²,

Winter³

2018

ORL

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Transoral robotic surgery has shown significant promise in the management of oropharyngeal cancer since its description in 2007. The oncological efficacy of this procedure has been proven in several single-centre studies, multicentre collaborative publications and systematic reviews. The rapid take-up of transoral robotic surgery shows greater acceptance by professionals and is associated with a relatively short learning curve. This overview discusses the rationale and principles underlying the use of transoral robotic surgery in primary and recurrent oropharyngeal cancer and the emerging role for this technique in diagnosing the unknown primary site, and summarizes ongoing research in this field.

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HPV-Related Oropharynx Cancer in the United Kingdom: An Evolution in the Understanding of Disease Etiology

Cited by 138 publications

References 28 publications

Epidemiologic associations of HPV‐positive oropharyngeal cancer and (pre)cancerous cervical lesions

Epidemiologic associations of HPV‐positive oropharyngeal cancer and (pre)cancerous cervical lesions

HPV in Head and Neck Carcinomas: Different HPV Profiles in Oropharyngeal Carcinomas – Why?

Transoral Robotic Surgery for Oropharyngeal Cancer

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