HN 08-03HUMAN PAPILLOMAVIRUS INFECTION AND HEAD AND NECK CANCERS IN MONTREAL, CANADA: RESULTS FROM THE HENCE LIFE CASE-CONTROL STUDY

22. HPV and oropharynx / Head and neck cancer
C. Laprise 1, S.A. Madathil 2, N.F. Schlecht 3, D. Soulières 4, P.F. Nguyen-Tan 5, G. Castonguay 6, P. Allison 6, F. Coutlée 7, M.C. Rousseau 2, E.L. Franco 8, B. Nicolau 6.
1Department of Oncology,Division of Cancer Epidemiology, McGill University, Montreal; Oral Health and Society Division, McGill University, Montreal (Canada), 2Oral Health and Society Division, McGill University, Montreal; Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval (Canada), 3Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York (United States), 4Department of Hemato-Oncology, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal (Canada), 5Department of Radiation Oncology, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal (Canada), 6Oral Health and Society Division, McGill University, Montreal (Canada), 7Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de l'Université de Montréal, Montreal (Canada), 8Department of Oncology, Division of Cancer Epidemiology, McGill University, Montreal (Canada)

Background / Objectives

Human papillomavirus (HPV) is a strong risk factor for a subset of head and neck cancers (HNCs), primarily oropharynx cancers. However, the distribution of specific HPV genotypes and their association with risk of cancer in anatomical subsites needs to be better understood. Our objectives were to describe HPV prevalence and to estimate the extent with which HPV infection is associated with HNC risk overall and for oral cavity, larynx, and oropharynx cancers. 


Methods

The Canadian site of the HeNCe Life study, an international hospital-based case-control study, recruited 389 incident HNC cases from four hospitals in the Montreal area. A total of 429 controls from outpatient clinics at the same hospitals as the cases were recruited and frequency-matched by age and sex. Data collected through interviews included socio-demographic, environmental and behavior information. Oral rinse and oral brush specimen, collected in both cases and controls, were analyzed for HPV positivity and HPV genotyping. HPV status was categorized as either negative, HPV other than alpha-9 species, alpha-9 other than HPV16, or HPV16. Unconditional logistic regression were used to estimate odds ratios (OR) and 95% confidence intervals (CI) for the associations between HPV infection and HNC, while adjusting for age, sex, number of educational years, and lifetime smoking and alcohol consumption. 


Results

HPV DNA was detected in 41.9% of cases and 14.2% of controls. The prevalence of HPV infection in cases was 62.6% in the oropharynx, 26.5% in the larynx and 20.0% in the oral cavity. HPV16 was the most prevalent genotype detected among both cases (29.8%) and controls (2.3%); 48.1% of oropharynx cancer cases tested positive for HPV16. HPV infection was associated with an increased risk of HNC in both oral brush (OR=8.6; 95% CI 4.6-15.8) or oral rinse samples (OR=4.1; 95% CI 2.9-5.8). Similarly, associations were observed for oropharyngeal subsite cancers both in oral brush specimen (OR=18.4; 95% CI 9.7-34.7) and oral rinse (OR=9.1; 95% CI 5.9-13.8, oral rinse). HNC risk was moderately associated with HPVs alpha-9 other than HPV16 (OR=2.9; 95% CI, 1.2-7.1). HNC risk was strongly associated with HPV16, especially for oropharynx (OR=45.5; 95% CI, 22.3-91.9), relative to larynx (OR=3.1; 95% CI, 1.1-8.5) and oral cavity (OR=4.5; 95% CI, 1.4-14.1) sites. 


Conclusion

As expected, HPV infection was associated with an increased HNC risk, especially HPV16 with oropharyngeal cancer. In our study, the role of HPV in HNC risk varies by HNC subsite and is related to HPV genotype. 


References