1887

Abstract

A significant proportion of mucosal squamous cell carcinomas of the head and neck (HNSCC; particularly of the oropharynx) are directly attributable to the human papillomavirus (HPV). The increase in the incidence of HPV-related tumours has been postulated to be due to changing sexual practices in the community. We analysed 136 formalin-fixed paraffin-embedded squamous cell carcinomas from the oral cavity (n=40) and oropharynx (n=96) recruited from the Princess Alexandra Hospital (Brisbane, Australia). Samples were analysed for the presence of HPV DNA using a combination of mucosal HPV general primer GP+ PCR and sequencing; p expression was assessed by immunohistochemistry. Each patient completed a questionnaire detailing their lifestyle factors, such as tobacco smoking and alcohol consumption, marital status, and sexual behaviour and history. The HPV DNA prevalence was 5 % in the oral cavity cancers and 72 % in the oropharyngeal cancers (P<0.0001). HPV-16 was the most commonly detected HPV type (found in 91 % of all HPV-positive tumours). There was a strong correlation between HPV DNA positivity and positive p16 staining in oropharyngeal tumours (P<0.0001). Having an HPV-related tumour was associated with being married or having been married previously (P=0.046), an increasing number of passionate kissing partners (P=0.046), ever having given oral sex (P=0.0007) and an increasing number of oral sex partners (P=0.0015). This study found a higher prevalence of HPV in oropharyngeal compared to oral cavity tumours, with a strong association being identified between oral sex behaviours and HPV-positive tumours. Further research is needed to establish that vaccines will reduce the transmission and carriage of oropharyngeal HPV infections.

Loading

Article metrics loading...

/content/journal/jgv/10.1099/jgv.0.001069
2018-04-30
2019-09-18
Loading full text...

Full text loading...

/deliver/fulltext/jgv/99/6/783.html?itemId=/content/journal/jgv/10.1099/jgv.0.001069&mimeType=html&fmt=ahah

References

  1. Whang SN, Filippova M, Duerksen-Hughes P. Recent progress in therapeutic treatments and screening strategies for the prevention and treatment of HPV-associated head and neck cancer. Viruses 2015;7:5040–5065 [CrossRef][PubMed]
    [Google Scholar]
  2. Ndiaye C, Mena M, Alemany L, Arbyn M, Castellsagué X et al. HPV DNA, E6/E7 mRNA, and p16INK4a detection in head and neck cancers: a systematic review and meta-analysis. Lancet Oncol 2014;15:1319–1331 [CrossRef][PubMed]
    [Google Scholar]
  3. AIHW Head and Neck Cancers in Australia Canberra: 2014
    [Google Scholar]
  4. Suh Y, Amelio I, Guerrero Urbano T, Tavassoli M. Clinical update on cancer: molecular oncology of head and neck cancer. Cell Death Dis 2014;5:e1018 [CrossRef][PubMed]
    [Google Scholar]
  5. Benson E, Li R, Eisele D, Fakhry C. The clinical impact of HPV tumor status upon head and neck squamous cell carcinomas. Oral Oncol 2014;50:565–574 [CrossRef][PubMed]
    [Google Scholar]
  6. Dok R, Nuyts S. HPV positive head and neck cancers: molecular pathogenesis and evolving treatment strategies. Cancers 2016;8:41 [CrossRef][PubMed]
    [Google Scholar]
  7. Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 2011;29:4294–4301 [CrossRef][PubMed]
    [Google Scholar]
  8. Herrero R, Castellsagué X, Pawlita M, Lissowska J, Kee F et al. Human papillomavirus and oral cancer: the International Agency for Research on Cancer multicenter study. J Natl Cancer Inst 2003;95:1772–1783 [CrossRef][PubMed]
    [Google Scholar]
  9. Spence T, Bruce J, Yip K, Liu F-F. HPV associated head and neck cancer. Cancers 2016;8:75 [CrossRef]
    [Google Scholar]
  10. Mehanna H, Beech T, Nicholson T, El-Hariry I, McConkey C et al. Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer–systematic review and meta-analysis of trends by time and region. Head Neck 2013;35:747–755 [CrossRef][PubMed]
    [Google Scholar]
  11. Rettig E, Kiess AP, Fakhry C. The role of sexual behavior in head and neck cancer: implications for prevention and therapy. Expert Rev Anticancer Ther 2015;15:35–49 [CrossRef][PubMed]
    [Google Scholar]
  12. Tran N, Rose BR, O'Brien CJ. Role of human papillomavirus in the etiology of head and neck cancer. Head Neck 2007;29:64–70 [CrossRef][PubMed]
    [Google Scholar]
  13. Pannone G, Santoro A, Papagerakis S, Lo Muzio L, de Rosa G et al. The role of human papillomavirus in the pathogenesis of head & neck squamous cell carcinoma: an overview. Infect Agent Cancer 2011;6:4 [CrossRef][PubMed]
    [Google Scholar]
  14. Porceddu SV, Milne R, Brown E, Bernard A, Rahbari R et al. Validation of the ICON-S staging for HPV-associated oropharyngeal carcinoma using a pre-defined treatment policy. Oral Oncol 2017;66:81–86 [CrossRef][PubMed]
    [Google Scholar]
  15. D'Souza G, Cullen K, Bowie J, Thorpe R, Fakhry C. Differences in oral sexual behaviors by gender, age, and race explain observed differences in prevalence of oral human papillomavirus infection. PLoS One 2014;9:e86023 [CrossRef][PubMed]
    [Google Scholar]
  16. Gillison ML, Broutian T, Pickard RK, Tong ZY, Xiao W et al. Prevalence of oral HPV infection in the United States, 2009–2010. JAMA 2012;307:693–703 [CrossRef][PubMed]
    [Google Scholar]
  17. D'Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007;356:1944–1956 [CrossRef][PubMed]
    [Google Scholar]
  18. Gillison ML, D'Souza G, Westra W, Sugar E, Xiao W et al. Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. J Natl Cancer Inst 2008;100:407–420 [CrossRef][PubMed]
    [Google Scholar]
  19. Antonsson A, Neale RE, Boros S, Lampe G, Coman WB et al. Human papillomavirus status and p16(INK4A) expression in patients with mucosal squamous cell carcinoma of the head and neck in Queensland, Australia. Cancer Epidemiol 2015;39:174–181 [CrossRef][PubMed]
    [Google Scholar]
  20. Emmett S, Jenkins G, Boros S, Whiteman DC, Panizza B et al. Low prevalence of human papillomavirus in oral cavity squamous cell carcinoma in Queensland, Australia. ANZ J Surg 2017;87:714–719 [CrossRef][PubMed]
    [Google Scholar]
  21. Hong A, Lee CS, Jones D, Veillard AS, Zhang M et al. Rising prevalence of human papillomavirus-related oropharyngeal cancer in Australia over the last 2 decades. Head Neck 2016;38:743–750 [CrossRef][PubMed]
    [Google Scholar]
  22. Lydiatt WM, Patel SG, O'Sullivan B, Brandwein MS, Ridge JA et al. Head and Neck cancers-major changes in the American Joint Committee on cancer eighth edition cancer staging manual. CA Cancer J Clin 2017;67:122–137 [CrossRef][PubMed]
    [Google Scholar]
  23. Ang KK, Zhang Q, Rosenthal DI, Nguyen-Tan PF, Sherman EJ et al. Randomized phase III trial of concurrent accelerated radiation plus cisplatin with or without cetuximab for stage III to IV head and neck carcinoma: RTOG 0522. J Clin Oncol 2014;32:2940–2950 [CrossRef][PubMed]
    [Google Scholar]
  24. Antonsson A, Cornford M, Perry S, Davis M, Dunne MP et al. Prevalence and risk factors for oral HPV infection in young Australians. PLoS One 2014;9:e91761 [CrossRef][PubMed]
    [Google Scholar]
  25. Kreimer AR, Pierce Campbell CM, Lin HY, Fulp W, Papenfuss MR et al. Incidence and clearance of oral human papillomavirus infection in men: the HIM cohort study. Lancet 2013;382:877–887 [CrossRef][PubMed]
    [Google Scholar]
  26. Sivasithamparam J, Visk CA, Cohen EE, King AC. Modifiable risk behaviors in patients with head and neck cancer. Cancer 2013;119:2419–2426 [CrossRef][PubMed]
    [Google Scholar]
  27. Smith EM, Ritchie JM, Summersgill KF, Klussmann JP, Lee JH et al. Age, sexual behavior and human papillomavirus infection in oral cavity and oropharyngeal cancers. Int J Cancer 2004;108:766–772 [CrossRef][PubMed]
    [Google Scholar]
  28. Schnelle C, Whiteman DC, Porceddu SV, Panizza BJ, Antonsson A. Past sexual behaviors and risks of oropharyngeal squamous cell carcinoma: a case-case comparison. Int J Cancer 2017;140:1027–1034 [CrossRef][PubMed]
    [Google Scholar]
  29. Chambers WC. Oral sex: varied behaviors and perceptions in a college population. J Sex Res 2007;44:28–42 [CrossRef][PubMed]
    [Google Scholar]
  30. de Roda Husman AM, Walboomers JM, van den Brule AJ, Meijer CJ, Snijders PJ. The use of general primers GP5 and GP6 elongated at their 3' ends with adjacent highly conserved sequences improves human papillomavirus detection by PCR. J Gen Virol 1995;76:1057–1062 [CrossRef][PubMed]
    [Google Scholar]
  31. de Roda Husman AM, Walboomers JM, Hopman E, Bleker OP, Helmerhorst TM et al. HPV prevalence in cytomorphologically normal cervical scrapes of pregnant women as determined by PCR: the age-related pattern. J Med Virol 1995;46:97–102 [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jgv/10.1099/jgv.0.001069
Loading
/content/journal/jgv/10.1099/jgv.0.001069
Loading

Data & Media loading...

Supplementary File 1

PDF

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error