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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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1 L’Hospitalet de Llobregat, Cancer Epidemiology Research Program, Institut Català d’Oncologia (ICO), Barcelona, Spain (GRID:grid.417656.7); L’Hospitalet de Llobregat, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain (GRID:grid.417656.7)
2 L’Hospitalet de Llobregat, Cancer Epidemiology Research Program, Institut Català d’Oncologia (ICO), Barcelona, Spain (GRID:grid.417656.7); L’Hospitalet de Llobregat, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain (GRID:grid.417656.7); University of Barcelona, Barcelona, Spain (GRID:grid.5841.8) (ISNI:0000 0004 1937 0247)
3 L’Hospitalet de Llobregat, Cancer Epidemiology Research Program, Institut Català d’Oncologia (ICO), Barcelona, Spain (GRID:grid.417656.7); L’Hospitalet de Llobregat, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain (GRID:grid.417656.7); University of Barcelona, Barcelona, Spain (GRID:grid.5841.8) (ISNI:0000 0004 1937 0247); L’Hospitalet de Llobregat, Department of Medical Oncology, ICO, Barcelona, Spain (GRID:grid.417656.7); L’Hospitalet de Llobregat, Program of Molecular Mechanisms and Experimental Therapy in Oncology (ONCOBELL), IDIBELL, Barcelona, Spain (GRID:grid.417656.7)
4 L’Hospitalet de Llobregat, Tobacco Control Unit, WHO Collaborating Centre for Tobacco Control, ICO, IDIBELL, Barcelona, Spain (GRID:grid.417656.7); Universitat Oberta de Catalunya, Department of E-Health, Faculty of Health Sciences, Barcelona, Spain (GRID:grid.36083.3e) (ISNI:0000 0001 2171 6620)
5 Hospital del Mar, Department of Pathology, Barcelona, Spain (GRID:grid.411142.3) (ISNI:0000 0004 1767 8811)
6 Hospital General de L’Hospitalet, Department of Pathology, Barcelona, Spain (GRID:grid.411142.3)
7 Hospital de Sant Pau, Department of Otorhinolaryngology, Barcelona, Spain (GRID:grid.413396.a) (ISNI:0000 0004 1768 8905); Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427)
8 B-ARGO Group, Department of Medical Oncology, ICO, Badalona, Spain (GRID:grid.413448.e)
9 L’Hospitalet de Llobregat, Department of Plastic Surgery, Bellvitge University Hospital, Barcelona, Spain (GRID:grid.417656.7)
10 Corporació Sanitària Parc Taulí, Department of Medical Oncology, Sabadell, Spain (GRID:grid.428313.f) (ISNI:0000 0000 9238 6887)
11 Corporació Sanitària Parc Taulí, Department of Otorhinolaryngology, Sabadell, Spain (GRID:grid.428313.f) (ISNI:0000 0000 9238 6887)
12 Hospital del Mar, Department of Medical Oncology, Barcelona, Spain (GRID:grid.411142.3) (ISNI:0000 0004 1767 8811)
13 Hospital del Mar, Department of Otorhinolaryngology, Barcelona, Spain (GRID:grid.411142.3) (ISNI:0000 0004 1767 8811)
14 L’Hospitalet de Llobregat, Pla Director d’Oncologia, ICO, IDIBELL, Barcelona, Spain (GRID:grid.417656.7); Universitat de Barcelona, Dept. Ciències Clíniques, Barcelona, Spain (GRID:grid.5841.8) (ISNI:0000 0004 1937 0247)
15 L’Hospitalet de Llobregat, Cancer Epidemiology Research Program, Institut Català d’Oncologia (ICO), Barcelona, Spain (GRID:grid.417656.7); L’Hospitalet de Llobregat, Epidemiology, Public Health, Cancer Prevention and Palliative Care Program, Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain (GRID:grid.417656.7); Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain (GRID:grid.413448.e) (ISNI:0000 0000 9314 1427)