Abstract
Background
Increases in incidence of oropharyngeal squamous cell carcinoma (OPSCC) in countries
with falling tobacco use have been attributed to a growing role of human papilloma
virus (HPV) in the carcinogenesis. Trends of HPV prevalence in populations with persistently
high portions of smokers are poorly characterised.
Patients and methods
Registry data from East Germany were used to determine incidence trends between 1998
and 2011. Data from patients treated at the Charité University Medicine Berlin between
2004 and 2013 (cohort 1, N = 436) were used for estimation of trends in HPV prevalence, smoking and survival. HPV
prevalence was prospectively confirmed in cohort 2 (N = 213) comprising all primary HNSCC cases at the Charité in 2013.
Results
Between 1998 and 2011 incidence of both OPSCC and non-OPSCC increased. An increase
in HPV prevalence (% of HPV+ cases in 2004–2006 versus 2012–2013: 27% versus 59%,
P = 0.0004) accompanied by a moderate decrease in the portion of current smokers was observed
in OPSCC but not in non-OPSCC. The change in disease epidemiology in OPSCC was associated
with significant improvement in overall survival. Increased HPV prevalence in OPSCC
(48%) compared to non-OPSCC (11%) was confirmed in cohort 2.
Conclusions
Despite clear differences to the United States in terms of tobacco use, the increase
in OPSCC incidence in a European population was also mainly attributed to HPV, and
the HPV status significantly affected prognosis. For clinical trial design it is important
to consider the large group of smokers within HPV-induced OPSCC.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to European Journal of CancerAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Etiological involvement of oncogenic human papillomavirus in tonsillar squamous cell carcinomas lacking retinoblastoma cell cycle control.Cancer Res. 1998; 58: 5-13
- Morphological and immunohistochemical evidence suggesting human papillomavirus (HPV) involvement in oral squamous cell carcinogenesis.Int J Oral Surg. 1983; 12: 418-424
- Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States.J Clin Oncol. 2008; 26: 612-619
- Human papillomavirus and rising oropharyngeal cancer incidence in the United States.J Clin Oncol. 2011; 29: 4294-4301
- Treatment-related outcome of oropharyngeal cancer patients differentiated by HPV dictated risk profile: a tertiary cancer centre series analysis.Ann Oncol. 2014; 25: 694-699
- Time trends in the prevalence of HPV in oropharyngeal squamous cell carcinomas in northern Spain (1990–2009).Int J Cancer. 2014; 134: 487-492
- 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
- Incidence and survival trends of head and neck squamous cell carcinoma in the Netherlands between 1989 and 2011.Oral Oncol. 2014; 50: 670-675
- Effect of HPV-associated p16INK4A expression on response to radiotherapy and survival in squamous cell carcinoma of the head and neck.J Clin Oncol. 2009; 27: 1992-1998
- Human papillomavirus and survival of patients with oropharyngeal cancer.N Engl J Med. 2010; 363: 24-35
- Impact of p16 status on the results of the phase III cetuximab (cet)/radiotherapy (RT).J Clin Oncol. 2014; 32 (abstract 6001)
- Survival and human papillomavirus in oropharynx cancer in TAX 324: a subset analysis from an international phase III trial.Ann Oncol. 2011; 22: 1071-1077
- Impact of tumor HPV status on outcome in patients with recurrent and/or metastatic squamous cell carcinoma of the head and neck receiving chemotherapy with or without cetuximab: retrospective analysis of the phase III EXTREME trial.Ann Oncol. 2014; 25: 801-807
- Tumor stage, human papillomavirus and smoking status affect the survival of patients with oropharyngeal cancer: an Italian validation study.Ann Oncol. 2012; 23: 1832-1837
- Worldwide trends in incidence rates for oral cavity and oropharyngeal cancers.J Clin Oncol. 2013; 31: 4550-4559
- Germany SimSmoke: the effect of tobacco control policies on future smoking prevalence and smoking-attributable deaths in Germany.Nicotine Tob Res. 2013; 15: 465-473
- Increasing prevalence rates of HPV attributable oropharyngeal squamous cell carcinomas in the Netherlands as assessed by a validated test algorithm.Int J Cancer. 2013; 132: 1565-1571
- Incidence of human papillomavirus (HPV) positive tonsillar carcinoma in Stockholm, Sweden: an epidemic of viral-induced carcinoma?.Int J Cancer. 2009; 125: 362-366
- Incidence of human papillomavirus positive tonsillar and base of tongue carcinoma: a stabilisation of an epidemic of viral induced carcinoma?.Eur J Cancer. 2014;
- Cigarette smoking, bacterial pneumonia, and other clinical outcomes in HIV-1 infection. Terry Beirn Community Programs for Clinical Research on AIDS.J Acquir Immune Defic Syndr Hum Retrovirol. 1996; 13: 374-383
- Trends of tobacco use in Sweden and Finland: do differences in tobacco policy relate to tobacco use?.Scand J Public Health. 2009; 37: 153-160
- The effect of tobacco control policies on smoking prevalence and smoking-attributable deaths. Findings from the Netherlands SimSmoke Tobacco Control Policy Simulation Model.Addiction. 2012; 107: 407-416
- Oral human papillomavirus (HPV) infection in HPV-positive patients with oropharyngeal cancer and their partners.J Clin Oncol. 2014;
- 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
- E1308: Reduced-dose IMRT in human papilloma virus (HPV)-associated resectable oropharyngeal squamous carcinomas (OPSCC) after clinical complete response (cCR) to induction chemotherapy (IC).J Clin Oncol. 2014; 32 (abstr LBA6006)
Article info
Publication history
Published online: January 23, 2015
Accepted:
December 20,
2014
Received:
December 11,
2014
Identification
Copyright
© 2015 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
