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Geographic Heterogeneity in the Prevalence of Human Papillomavirus in Head and Neck Cancer


Anantharaman, Devasena; Abedi-Ardekani, Behnoush; Beachler, Daniel C.; Gheit, Tarik; Olshan, Andrew F.; Wisniewski, Kathy; Wunsch-Filho, Victor; Toporcov, Tatiana N.; Tajara, Eloiza H.; & Levi, Jose Eduardo, et al. (2017). Geographic Heterogeneity in the Prevalence of Human Papillomavirus in Head and Neck Cancer. International Journal of Cancer, 140(9), 1968-1975.


Human papillomavirus (HPV) causes oropharyngeal squamous cell carcinoma (OPSCC), although strongly divergent results have been reported regarding the prevalence of HPV16 in different countries, whether this represents important differences in etiology remains unclear. Applying rigorous protocols for sample processing, we centrally evaluated 1420 head and neck tumors (533 oropharynx, 395 oral cavity and 482 larynx) from studies conducted in the US, Europe and Brazil for mucosal HPV DNA and p16INK4a expression to evaluate regional heterogeneity in the proportion of HPV16-associated OPSCC and other head and neck cancer, and to assess covariates associated with the risk of HPV16-positive OPSCC. While majority of OPSCC in the US (60%) were HPV16-positive, this proportion was 31% in Europe and only 4% in Brazil (p<0.01). Similar differences were observed for other head and neck tumors, ranging from 7% in the US and 5% in Europe, to 0% in South America. The odds of HPV16-positive OPSCC declined with increasing pack years of smoking (OR: 0.75; 95% CI: 0.64 -0.87) and drink years of alcohol use (OR: 0.64; 95% CI: 0.54-0.76). These results suggest that while the contribution of HPV16 is substantial for the oropharynx, it remains limited for oral cavity and laryngeal cancers.


Reference Type

Journal Article

Year Published


Journal Title

International Journal of Cancer


Anantharaman, Devasena
Abedi-Ardekani, Behnoush
Beachler, Daniel C.
Gheit, Tarik
Olshan, Andrew F.
Wisniewski, Kathy
Wunsch-Filho, Victor
Toporcov, Tatiana N.
Tajara, Eloiza H.
Levi, Jose Eduardo
Moyses, Raquel A.
Boccia, Stefania
Cadoni, Gabriella
Rindi, Guido
Ahrens, Wolfgang
Merletti, Franco
Conway, David I.
Wright, Sylvia
Carreira, Christine
Renard, Helene
Chopard, Priscilia
McKay-Chopin, Sandrine
Scelo, Ghislaine
Tommasino, Massimo
Brennan, Paul
D'Souza, Gypsyamber