The current epidemic of HPV-associated oropharyngeal cancer: An 18-year Danish population-based study with 2, 169 patients. (July 2020)

• Record Type: Journal Article
• Authors: Zamani, Martin; Grønhøj, Christian; Jensen, David H.; Carlander, Amanda F.; Agander, Tina; Kiss, Katalin; Olsen, Caroline; Baandrup, Louise; Nielsen, Finn C.; Andersen, Elo; Friborg, Jeppe; von Buchwald, Christian
• Is Part Of: European journal of cancer. Volume 134(2020)
• Page Start: 52
• Page End: 59
• Publication Date: 2020-07
• Subjects: Human papillomavirus -- Squamous cell carcinoma -- Oropharyngeal cancer -- Tonsil cancer; Cancer -- Periodicals; Neoplasms -- Periodicals; Cancer -- Périodiques; Cancer; Tumors; Electronic journals; Periodicals; Electronic journals; 616.994
• DOI: 10.1016/j.ejca.2020.04.027
• Languages: English
• ISSNs: 0959-8049

Abstract

Abstract: Background: The objectives of this study were to investigate the incidence of high-risk genotypes of human papillomavirus (HPV) in tumours of patients with oropharyngeal squamous cell carcinoma (OPSCC) during an 18-year period in Eastern Denmark. Methods: In this population-based, consecutive, semi-national registry study, all patients diagnosed with OPSCC from 2000 to 2017 in Eastern Denmark were evaluated at head and neck oncological departments at public university hospitals. Analyses included tumour characteristics (HPV-positive [HPV+] versus HPV-negative [HPV–]), age-adjusted incidence rates (AAIRs), average annual percentage change (AAPC) of OPSCC, and patient demographics. All HPV+ cases from 2011 to 2017 were genotyped. Results: In total, 55% of 2169 OPSCC cases were HPV+. HPV16, HPV33, HPV35 or other types were found in 86%, 7.4%, 3.4% and 3.2% of cases, respectively. The AAIR per 100, 000 of all OPSCCs was 1.8 in 2000, which increased to 5.1 in 2017 (HPV+: threefold increase, HPV–: twofold increase). The AAPC from 2000 to 2017 increased by 7% (HPV+ increased by 10% and HPV– by 4%). The median age at diagnosis for all OPSCC cases increased during the 18-year study period (HPV+: 58–61 years, p < 0.001; HPV–: 60–65 years, p < 0.001). Conclusion: We report a threefold increase in OPSCC incidence during the 18-year observation period and a significant increase in median age at diagnosis. Over 93% of HPV genotypes in HPV+ OPSCC are included in current HPV vaccines except for HPV35 (4%). HPV vaccination of both sexes is advised to halt this emerging cancer epidemic. Highlights: The current largest register-based study in Eastern Denmark of HPV-tested Oropharyngeal Squamous Cell Carcinoma (OPSCC). All confirmed OPSCC cases (n= 2169) from 2000-2017 were included and tested for HPV DNA and p16 expression. HPV-positive tumours had the viral DNA genotyped (n= 770) to examine high-risk genotypes. HPV16 was the most common genotype (86%) among HPV-positive cases. The incidence rate of OPSCC increased threefold overall, especially for HPV-positive OPSCC of the tonsils.