Human papillomavirus‐active head and neck cancer and ethnic health disparities

Abstract

OBJECTIVES/HYPOTHESIS-Mortality for black males with head and neck squamous cell carcinoma (HNSCC) is twice that of white males or females. Human papillomavirus (HPV)-active HNSCC, defined by the concurrent presence of high-risk type HPV DNA and host cell p16 INK4a expression, is associated with decreased mortality. We hypothesized that prevalence of this HPVactive disease class would be lower in black HNSCC patients compared to white patients. RESULTS-There were 140 patients with HNSCC who met inclusion criteria. Self-reported ethnicity was white (115), black (25), and other (0). Amplifiable DNA was recovered from 102/140 patients. The presence of HPV DNA and the level of p16 INK4a expression were determined and the results were used to classify these patients as HPV-negative (44), HPVinactive (33) and . Patients with HPV-active HNSCC had improved overall 5-year survival (59.7%) compared to HPV-negative and HPV-inactive patients (16.9%) (P=0.003). Black patients were less likely to have HPV-active disease (0%) compared to white patients (21%), P=0.017. STUDY DESIGN-Multi-institutional retrospective cohort analysis. METHODS-Real-time CONCLUSIONS-The favorable HPV-active disease class is less common in black than in white patients with HNSCC, which appears to partially explain observed ethnic health disparities.

Correlation of p16 expression and HPV type with survival in oropharyngeal squamous cell cancer

“…In that study, there was no racial difference in survival in non-oropharyngeal sites; the more favorable overall survival in white patients with OPSCC was driven by increased prevalence of [38]. In contrast, Weinberger et al and Isayeva et al noticed no significant racial HPV prevalence between blacks and whites in their studies, but racial differences in survival could be accounted for by pairing HPV and p16 co-results [30,39]. Weinberger et al found in their study that black patients were much more likely than whites to have prognostically unfavorable HPV+/p16À or ''HPV inactive'' OPSCCs [40].…”

“…The LAHPV test detects 37 high and low risk HPV types including all 12 types classified as carcinogenic (IARC Group 1: 16,18,31,33,35,39,45,51,52,56,58 and 59), the single type classified as probably carcinogenic (IARC Group 2A: 68), 7 types classified as possibly carcinogenic (IARC Group 2B: 26, 53, 66, 67, 70, 73 and 82) and 17 other types. All tests were run with manufacturer's positive and negative controls.…”

Meta-analysis of survival in patients with HNSCC discriminates risk depending on combined HPV and p16 status

“…Table 2 indicates the number of patients belonging to the different subgroups depending on the HPV and p16-status. The proportion of the subgroups was estimated from the 16 studies, which explicitly indicated the patient number [11,15,25,26,34,36,43,47,48,58,62,68,69,75,80,82]. The subgroup of HPV ?…”

HPV Infection and Anemia Status Stratify the Survival of Early T2 Laryngeal Squamous Cell Carcinoma

“…Weinberger et al 16 showed no difference in survival between HPVÀ/p16À and HPV+/p16À OPSCCs, but they did not analyze the difference between HPV+/p16À and HPV+/p16+ cases. In 2010, the investigator also demonstrated the different survival between HPV+/p16+, HPV+/p16À, and HPVÀ/p16À cases in HNSCCs, 17 but the difference between HPV+/p16À and HPVÀ/p16À cases was not analyzed. Our result showed an obviously discrete trend in OS and RFS among the three classes.…”