Incidence of human papillomavirus positive tonsillar and base of tongue carcinoma: A stabilisation of an epidemic of viral induced carcinoma?

Näsman, Anders; Nordfors, Cecilia; Holzhauser, Stefan; Vlastos, Andrea; Tertipis, Nikolaos; Hammar, Ulf; Hammarstedt‐Nordenvall, Lalle; Marklund, Linda; Munck‐Wikland, Eva; Ramqvist, Torbjörn; Bottai, Matteo; Dalianis, Tina

doi:10.1016/j.ejca.2014.10.016

Cited by 60 publications

(74 citation statements)

References 35 publications

(87 reference statements)

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“…The proportion of HPV + HNCUP was 40% 2000-2007 compared to 63% in the 2008-2013, possibly indicating an increasing trend, but the difference was not statistically significant. Nevertheless, the proportion of HPV + tumours in the 2008-2013 was relatively similar to that reported for tonsillar and base of tongue SCC during the same period (7,24).…”

Section: Discussionsupporting

confidence: 82%

Validation of Human Papillomavirus as a Favourable Prognostic Marker and Analysis of CD8+ Tumour-infiltrating Lymphocytes and Other Biomarkers in Cancer of Unknown Primary in the Head and Neck Region

Sivars¹,

Landin²,

Grün³

et al. 2017

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Abstract. Background: Human papillomavirus (HPV) is a favourable prognostic factor in oropharyngeal cancer. Moreover, we and others reported that HPV-positive cancer of unknown primary in the head and neck region (HNCUP) has better outcome than HPVHead and neck squamous cell carcinoma (HNSCC), including cancer of the pharynx, larynx, oral cavity, nose and nasal sinuses, often presents as a lump in the neck, and the specific site of the primary tumour is in general revealed after subsequent diagnostic procedures. However, in 2-9% of the cases the primary tumour is not found and the condition is denoted as cancer of unknown primary in the head and neck region (HNCUP) (1). Treatment of the latter has traditionally comprised of neck dissection followed by postoperative oncological treatment, i.e. radiotherapy, at times with the addition of platinum-based chemotherapy or cetuximab, while today in some cases only oncological treatment is given (2).Human papillomavirus (HPV)-associated oropharyngeal SCC is a HNSCC subset dominated by tonsillar and base of tongue SCC (3, 4). HPV-positive tonsillar and base of tongue SCC have increased in incidence in the past decades in the developed world and have better clinical outcomes than HNSCC in general [~80% vs. 40% 5-year overall survival (OS)] (5-8). HPV is frequently found in HNCUP and such cases likely have an HPV-positive oropharyngeal SCC origin, which gives reasons for steering diagnostic procedures as well as radiotherapy towards the oropharynx (9-11).Treatment de-escalation may be attainable in patients with HPV-positive HNCUP, similar to that discussed for patients with HPV-positive oropharyngeal SCC (12). Still, before HPV status of HNCUP can be used to guide treatment, more knowledge on the biology and clinical behaviour of the 665 Τhis article is freely accessible online.

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Section: Discussionsupporting

confidence: 82%

Validation of Human Papillomavirus as a Favourable Prognostic Marker and Analysis of CD8+ Tumour-infiltrating Lymphocytes and Other Biomarkers in Cancer of Unknown Primary in the Head and Neck Region

Sivars¹,

Landin²,

Grün³

et al. 2017

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“…This contrasts with previous data, detailing an increased proportion of HPVpositive OPSCC associated with increasing incidence of OPSCC overall. [8] Recent data from North America [10] and Stockholm, [23] however, suggest that plateaus in the proportion of HPV-positive OPSCC and HPV-positive tonsillar squamous cell carcinoma respectively, have been observed from the year 2000 onwards.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2016

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Tables: 2 (plus 3 supplemental tables) 4 AbstractA rising incidence of oropharyngeal squamous cell carcinoma (OPSCC) incidence has occurred throughout the developed world, where it has been attributed to an increasing impact of human papillomavirus (HPV) on disease etiology. This report presents the findings of a multicenter crosssectional retrospective study aimed at determining the proportion of HPV-positive and HPV-negative

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“…Such investigation could also have relevance for secondary prevention of oropharyngeal cancers. Here, we report on the association of tonsillectomy with risk of tonsillar, non-tonsillar oropharyngeal, and other head and neck cancers from a nation-wide, registrybased cohort study in Sweden, where oropharyngeal cancer incidence has significantly increased since 1970 (7,14,15). We also specifically quantified the extent to which declines in tonsillectomies in recent years have contributed to rising oropharyngeal cancer incidence.…”

Section: Introductionmentioning

confidence: 99%

Tonsillectomy and Incidence of Oropharyngeal Cancers

Chaturvedi

Song

Rosenberg

et al. 2016

Cancer Epidemiology, Biomarkers &Amp; Prevention

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Background: Rising incidence of oropharyngeal cancers in numerous countries since the 1970s has been attributed to increased oral human papillomavirus (HPV) exposure. However, the contribution of coincidental declines in the surgical removal of the tonsils (tonsillectomy) is unknown. We quantified the association of tonsillectomy with risk of tonsillar, other oropharyngeal, and other head and neck cancers and the contribution of declines in tonsillectomies to cancer incidence trends.Methods: We conducted a nation-wide cohort study in Sweden (1970Sweden ( -2009. Tonsillectomies (N ¼ 225,718) were identified through national patient registers, which were linked with the cancer register. Cancer incidence in the tonsillectomy cohort was compared with Sweden's general population through standardized incidence ratios (SIR).Results: Tonsillectomies were associated with reduced risk of tonsil cancers [SIRs 1þ years post-tonsillectomy ¼ 0.31; 95% confidence interval (CI), 0.08-0.79 and 5þ years post-tonsillectomy ¼ 0.17; 95% CI, 0.02-0.62], but unrelated to other oro-

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Incidence of human papillomavirus positive tonsillar and base of tongue carcinoma: A stabilisation of an epidemic of viral induced carcinoma?

Cited by 60 publications

References 35 publications

Validation of Human Papillomavirus as a Favourable Prognostic Marker and Analysis of CD8+ Tumour-infiltrating Lymphocytes and Other Biomarkers in Cancer of Unknown Primary in the Head and Neck Region

Validation of Human Papillomavirus as a Favourable Prognostic Marker and Analysis of CD8+ Tumour-infiltrating Lymphocytes and Other Biomarkers in Cancer of Unknown Primary in the Head and Neck Region

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

Tonsillectomy and Incidence of Oropharyngeal Cancers

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