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HPV behind nearly 75% of oropharyngeal cancer cases in Canada
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The proportion of oropharyngeal cancers associated with HPV in several cancer centers across Canada rose from nearly half to nearly three-quarters over 12 years, according to researchers.
“Across multiple centers in Canada, there was a steady rise in the proportion of oropharyngeal cancers attributable to HPV from 2000 to 2012,” study researcher Steven Habbous, MSc, of the Ontario Cancer Institute, and colleagues wrote in the Canadian Medical Association Journal.
The researchers collected data on 3,643 patients with the disease diagnosed between 2000 and 2012. The patients were treated at five comprehensive cancer centers in British Columbia, Calgary, Edmonton, Halifax and Toronto.
The researchers examined variables like smoking status, alcohol consumption and primary treatment, among others. They used the expression of p16 protein, a tumor suppressor, to identify HPV infection in patients with oropharyngeal cancer, citing prior studies validating the method.
Habbous and colleagues found that the proportion of oropharyngeal squamous cell cancer cases in which HPV was present increased from about 47% in 2000 to about 74% in 2012. The rate of increase over that period was greater in men than in women, they said. Among all patients with oropharyngeal cancer, the risk for mortality in those with tumors testing p16-negative was double that of those whose tumors were p16-positive.
The data make the case for more consistent HPV screening at cancer centers, the researchers said.
Before routine HPV testing was implemented, clinicians often reserved testing only for those patients who were most likely to have HPV positivity, according to the researchers.
However, studies began to show a greater role for HPV in oropharyngeal cancer.
“Only as accumulating data have supported the clinical importance of HPV testing has routine testing been implemented in most, though not all, Canadian centers,” study researcher Geoffrey Liu, MD, MSc, a senior scientist at Princess Margaret Hospital and the University of Toronto, said in the news release.
Liu and colleagues recommended routine HPV screening in all oropharyngeal cancer cases, as well as routine reporting of screening results. Liu said the data also highlight a reason to increase HPV vaccination in men.
“As three-quarters of these cancers occur in men, our results thus strengthen the case to vaccinate both sexes against HPV,” he said. – by Joe Green
Disclosure: The researchers report no relevant financial disclosures.
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