Human papillomavirus (HPV) 16 seropositivity is associated with survival in people with oropharyngeal cancer. The role of other HPV serotypes and HPV at other head and neck cancer sites is unclear. We used data from Head and Neck 5000 to estimate the prevalence of HPV antibodies in people with head and neck cancer at different sites and to describe differences in survival.
We used data from a large prospective UK clinical cohort of people with a new diagnosis of head and neck cancer recruited from April 2011 to December 2014. Prior to treatment, participants completed questionnaires and provided a blood sample. Clinical details were extracted from clinical notes. Review of pathology reports is ongoing so figures reported in the abstract may be subject to change. Blood samples were analysed using multiplex serology; HPV16 E6 seropositivity was defined as >1000 median fluorescence intensity. The role of other HPV16 antigens and antigens from other serotypes was explored. Date of death was obtained through record linkage with a mean follow up time of 2.6 years. Cox regression models included age, gender, stage (not for primary of unknown origin, PUO), treatment intent, smoking and co-morbidity.
The prevalence of HPV 16E6 positivity was 68.5% in 1,606 people with oropharyngeal cancer and increased to 71.8% when people with a response to at least three HPV16 or HPV18 antigens or paired E6 and E7 of other high HPV types were added. The survival of these additional people with oropharyngeal cancer defined as HPV positive was similar to those based on HPV16 E6 serology alone so they are included in survival analyses. The prevalence of HPV positivity was 55.9% in 134 people with PUO; 13.5% in 104 people with nasophrayngeal cancer; 9.8% in 195 people with hypopharyngeal cancer; 5.7% in 53 people with nasal cavity cancer and only 2.4% in 1120 people with oral cavity cancer; 2.1% in 911 people with laryngeal cancer and 1.8% in 115 people with major salivary gland cancer. Adjusted hazard ratios were 0.34 (95% CI 0.23 to 0.51) for oropharyngeal cancer; 0.17 (95% CI 0.02 to 1.45) for PUO; 0.25 (95% CI 0.07 to 0.90) for nasopharyngeal, hypopharyngeal and nasal cavity cancer combined and 0.85 (95% CI 0.39 to 1.83) for oral cavity, laryngeal and salivary gland cancer combined.
HPV seropositivity in the UK is high in people with oropharyngeal cancer and PUO. People with a PUO who are HPV seropositve appear to have a similar survival to people with oropharyngeal cancers. HPV seropositivity is lower in other sites and may be related to survival for nasopharyngeal, hypopharyngeal and nasal cavity cancer but not for oral cavity, larynx and salivary gland cancer.