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. 2020 Aug 6;10(1):13219.
doi: 10.1038/s41598-020-70118-7.

Epidemiology of human papillomavirus-related oropharyngeal cancer in a classically low-burden region of southern Europe

M Mena #  1   2 , J Frias-Gomez #  3   4   5 , M Taberna  3   4   5   6   7 , B Quirós  3   4 , S Marquez  3   4 , O Clavero  3   4 , A Baena  8   9 , B Lloveras  10 , M Alejo  11 , X León  12   13 , J García  12   13 , R Mesía  14 , O Bermejo  15 , T Bonfill  16 , A Aguila  17 , M Guix  18 , R Hijano  19 , M A Pavón  3   4 , M Torres  3   4 , S Tous  3   4 , R Clèries  20   21 , L Alemany  22   23   24
Affiliations

Epidemiology of human papillomavirus-related oropharyngeal cancer in a classically low-burden region of southern Europe

M Mena et al. Sci Rep. .

Abstract

The incidence of human papillomavirus (HPV)-related oropharyngeal cancer is increasing in some regions. Nevertheless, the epidemiology of this disease has not been extensively investigated in southern Europe. We conducted a retrospective cohort study of patients diagnosed with primary oropharyngeal cancer from 1991 to 2016. Cancer tissues underwent histopathological evaluation, DNA quality control, HPV-DNA detection and p16INK4a immunohistochemistry. Data were collected from medical records. Factors associated with HPV positivity and time trends were evaluated with multivariable Bayesian models. The adjusted prevalence of HPV-related cases in 864 patients with a valid HPV-DNA result was 9.7%, with HPV-DNA/p16INK4a double positivity being considered. HPV-related oropharyngeal cancer was likely to occur in non-smokers and non-drinkers, to be located in the tonsil or diagnosed at advanced stages. Time-trend analysis showed an increasing risk of HPV-related oropharyngeal cancer in the most recent periods (5-year period increase of 30%). This increase was highest and with a clear increasing trend only in the most recent years (2012-2016). The prevalence of HPV-related oropharyngeal cancer started to sharply increase in the most recent years in our setting, as occurred two decades ago in areas where most oropharyngeal cancer cases are currently HPV-related. Our results provide a comprehensive assessment of the epidemiological landscape of HPV-related oropharyngeal cancer in a region of southern Europe.

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Conflict of interest statement

RM has received personal fees and non-financial support from Merck, and personal fees from Astra Zeneca and MSD. MT has received scientific advisory board fees, speaker’s fees, travel grants or non-financial support from Merck, Astra Zeneca, Nanobiotics, MSD and Bristol Meyers. Cancer Epidemiology Research Program (LA, MM, JF, SM, ST, BQ, OC, MT, MTo, MP) has received sponsorship for grants from Merck and co, Roche, Reig-jofre, IDT, Seegene, Hologic and GSK. The rest of authors have declared no conflicts of interest.

Figures

Figure 1
Figure 1
Time trends of relative risk for HPV positivity in OPC. CI credibility interval; OPC oropharyngeal cancer. Time trends of relative risk for HPV positivity in OPC for each five years period with respect to reference one: 1991–1996. Trends models adjusted by age at diagnosis, gender, period of diagnosis, subsite, stage and tobacco and alcohol consumption. Y axis is represented in logarithmic scale.
Figure 2
Figure 2
Time trends of relative risk for HPV positivity in OPC by anatomical subsite and gender. CI credibility interval, BOT base of tongue. Time trends of relative risk for HPV positivity in OPC for each five years period with respect to reference one: 1991–1996. Trends models adjusted by age at diagnosis, gender, period of diagnosis, subsite, stage and tobacco and alcohol consumption. Y axis is represented in logarithmic scale.
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