Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Nov 15;76(22):6598-6606.
doi: 10.1158/0008-5472.CAN-16-0633. Epub 2016 Aug 28.

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

Andrew G Schache  1   2 , Ned G Powell  3 , Kate S Cuschieri  4 , Max Robinson  5 , Sam Leary  6 , Hisham Mehanna  7 , Davy Rapozo  8 , Anna Long  9 , Heather Cubie  4 , Elizabeth Junor  10 , Hannah Monaghan  11 , Kevin J Harrington  12   13 , Christopher M Nutting  13 , Ulrike Schick  12   13 , Andy S Lau  1   2 , Navdeep Upile  1   2 , Jon Sheard  14 , Kath Brougham  14 , Catharine M L West  15 , Ken Oguejiofor  15 , Steve Thomas  16 , Andy R Ness  6 , Miranda Pring  16 , Gareth J Thomas  17 , Emma V King  18 , Dennis J McCance  19 , Jacqueline A James  20 , Michael Moran  21 , Phil Sloan  5 , Richard J Shaw  1   2 , Mererid Evans  22 , Terry M Jones  23   2
Affiliations

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

Andrew G Schache et al. Cancer Res. .

Abstract

A 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 cross-sectional retrospective study aimed at determining the proportion of HPV-positive and HPV-negative OPSCC within the United Kingdom. Archival tumor tissue blocks from 1,602 patients previously diagnosed with OPSCC (2002-2011) were collated from 11 centers. HPV status was determined with three validated commercial tests to provide valid data for 1,474 cases in total. Corresponding national incidence data from the same decade were obtained from UK Cancer registries. The overall proportion of HPV+ OPSCC between 2002 and 2011 was 51.8% [95% confidence interval (CI), 49.3-54.4], and this remained unchanged throughout the decade [unadjusted RR = 1.00 (95% CI, 0.99-1.02)]. However, over the same period, the incidence of OPSCC in the broader UK population underwent a 2-fold increase [age-standardized rate 2002: 2.1 (95% CI, 1.9-2.2); 2011: 4.1 (95% CI, 4.0-4.3)]. Although the number of OPSCCs diagnosed within the United Kingdom from 2002 to 2011 nearly doubled, the proportion of HPV+ cases remained static at approximately 50%. Our results argue that the rapidly increasing incidence of OPSCC in the United Kingdom cannot be solely attributable to the influence of HPV. The parallel increase in HPV+ and HPV- cases we documented warrants further investigation, so that appropriate future prevention strategies for both types of disease can be implemented. Cancer Res; 76(22); 6598-606. ©2016 AACR.

PubMed Disclaimer

Conflict of interest statement

Disclosure of Potential Conflicts of Interest

N.G. Powell reports receiving a commercial research grant from GlaxoSmithKline, has received speakers bureau honoraria from GlaxoSmithKline and Sanofi Pasteur MSD, and is a consultant/advisory board member for Sanofi Pasteur MSD. K.S. Cuschieri reports receiving commercial research grants from GeneFirst and Euroimmun. M. Robinson is a consultant/advisory board member for Leica Biosystems Ltd. H. Mehanna reports receiving commercial research grants from GSK Biologicals, GSL PLC, MSD, Sanofi Pasteur, and Silence Therapeutics and has received speakers bureau honoraria from MSD, Merck, and Sanofi Pasteur. H. Cubie has received speakers bureau honoraria from the GSK expert panel. E. Junor has provided expert testimony as a reviewer of Belgium Head and Neck Guideline. C.M.L. West has received speakers bureau honoraria from Merck. T.M. Jones reports receiving a commercial research grant from GSK and has received speakers bureau honoraria from Sanofi Pasteur. No potential conflicts of interest were disclosed by the other authors.

Figures

Figure 1.
Figure 1.
Study schema. The HPV testing algorithm was applied in three tiers. Samples (1,474/1,529) were successfully classified as either HPV positive (red boxes) or negative (blue boxes). A total of 55 samples gave invalid data (gray boxes).
Figure 2.
Figure 2.
Proportion of OPSCC testing HPV positive over time, by individual tests and algorithm. The red line represents the proportion of samples classified as HPV positive using the algorithm shown in Fig. 1. Other lines show the results of individual tests.
Figure 3.
Figure 3.
Incidence of SSC of the oropharynx, larynx, and mouth (United Kingdom, 2002–2011). LSCC, laryngeal squamous cell carcinoma. Mouth comprises malignant neoplasms of the gum, floor of mouth, palate (excluding soft palate and uvula), and other unspecified parts of the mouth.
Figure 4.
Figure 4.
Estimated incidence of OPSCC by HPV status (United Kingdom, 2002–2011). For each year, the gender-specific proportion of HPV-positive samples was multiplied by the gender-specific incidence to estimate ASR for both HPV-positive and -negative OPSCC. Incidence of cancers of the mouth is also shown.
See this image and copyright information in PMC

References

    1. Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E, et al. Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 2011;29:4294–301. - PMC - PubMed
    1. Junor EJ, Kerr GR, Brewster DH. Oropharyngeal cancer. Fastest increasing cancer in Scotland, especially in men. BMJ 2010;340:c2512. - PubMed
    1. Office for National Statistics. Cancer Registration Statistics, England (Series MB1), No. 44; 2013. Available from: http://www.ons.gov.uk/ons/publications/re-reference-tables.html?edition=....
    1. D’Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch WM, et al. Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 2007;356:1944–56. - PubMed
    1. Heck JE, Berthiller J, Vaccarella S, Winn DM, Smith EM, Shan’gina O, et al. Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol 2010;39:166–81. - PMC - PubMed

Publication types