Epidemiologic associations of HPV-positive oropharyngeal cancer and (pre)cancerous cervical lesions

Abstract

Purpose: Human papillomavirus (HPV)- induced oropharyngeal squamous cell carcinoma (OPSCC) is still increasing worldwide. We aimed to investigate if the HPV-prevalence of OPSCC in the Netherlands is rising as well, especially in female patients. In addition, we evaluated the association between HPV-positive OPSCC and suspicious Pap results of the cervix in these female patients.

Patients and Methods: Patients with OPSCC treated in the period 2000-2015 at the VU University Medical Center Amsterdam, were included (n=926). The presence of an oncogenic HPV infection was determined by p16-immunostaining, followed by a high-risk HPV general primer 5+/6+ DNA PCR on the p16-immunopositive cases. A review of pathology reports in all female patients (n=305) was undertaken to identify cytological signs of HPV-related (pre)cancer of the cervix.

Results: In total, 281 of 926 (30.3%) OPSCCs were HPV-positive. Moreover, a significant increase in the prevalence of HPV-positive OPSCCs was observed from 14.0% in 2000 to 48.1% in 2015 (p<0.001). Among the female patients with an HPV-positive OPSSC (n=70), the results of cervical smears were available in 56 of 70 patients (80.0%). Of the female patients with HPV-positive OPSCC, 9 of 56 (16.1%) patients had a vaginal cuff Papanicolaou (Pap) test ≥3b in their medical history compared to 7 of 168 (4.2%) in the HPV-negative group (p=0.003).

Conclusions: A continuous increase in the HPV-attributable fraction of OPSCC was demonstrated in the period 2000- 2015 in the Amsterdam region. HPV-positive OPSCC has a significant association with a history of suspicious Pap results of the cervix in women. This article is protected by copyright. All rights reserved.

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