SS 05-01THE STATE OF THE ART OF HPV ASSOCIATION IN NON-GENITAL, NON-ORAL CANCERS. AN OVERVIEW.

27. HPV and oropharynx / Head and neck cancer
K. Syrjänen 1.
1Chief Medical Director, Biohit Oyj (Finland)

Background / Objectives

The first reports suggesting HPV involvement in  development of sino-nasal (SNC), laryngeal (LC), bronchial (BC) and esophageal cancer (EC) date back to the late 1970’s and early 1980’s. This overview summarizes the evidence accumulated during the past 35+ years, based on recent meta-analytical data of the published literature.


Methods

Literature published on HPV detection in sino-nasal-, laryngeal-, bronchial- and esophageal cancers and their benign counterparts (papillomas) was subjected to 7 separate  meta-analyses published in 2012-2015.  In all reports, the pooled prevalence was calculated as event rates (95% CI), with homogeneity testing using Cochran Q and I2 statistics. Meta-regression was used to test the impact of study-level covariates.


Results

Of sino-nasal carcinomas, 35 eligible studies, covering 492 SCCs from different geographic regions were included. Of those, 133 (27.0%) cases tested HPV-positive; pooled prevalence of 33.0% (95%CI, 24.9-42.3%; RE model). Seventy-six studies were eligible covering 1,956 sinonasal papillomas from all geographic regions. Altogether, 760 (38.8%) cases tested HPV-positive; effect size 42.1% (95%CI 35.9-48.5%, RE model). Of laryngeal SCCs, 180 studies were eligible comprising a sample size of 7,353 laryngeal SCCs. Of these, 1,833 (25%) tested HPV-positive (any methods); effect size 26.9% (95%CI 24.2-29.7%; RE model). Exactly 100 studies on lung cancer were eligible, covering 7,381 lung cancers (all histological types). In total, 1,653 (22.4%) samples tested HPV-positive; effect size was 22.0% (95% CI=18.0-25.9%; RE model). Of the 1,177 abstracts found on ESCC, 152 studies were consider eligible. These 152 studies covered 10,234 ESCC cases, analysed by different HPV detection methods. Altogether, 3,135 (30.6%) tested HPV-positive, translating to an effect size of 29.0% (95%CI 25.1-31.0; RE model).


Conclusion

The results of these published meta-analysis indicate that the reported wide variability in HPV detection in SNC, LC, BC and EC is not due to the HPV detection techniques, but best explained by the geographic origin of the study, except in SNC. In LC, also the histological type is a significant study-level covariate.


References

Syrjänen, K.J. Geographic origin is a significant determinant of human papillomavirus (HPV) prevalence in esophageal squamous cell carcinoma: systematic review and meta-analysis. Scand. J. Infect. Dis. 45, 1-18, 2013.

Syrjänen, K. and Syrjänen, S. Detection of human papillomavirus (HPV) in esophageal papillomas: systematic review and meta-analysis. APMIS. 121, 363-374, 2013.

Syrjänen, K.J. Detection of human papillomavirus (HPV) in lung cancer: systematic review and meta-analysis. Anticancer Res. 32, 3235-3250, 2012.                                 

Syrjänen, K. and Syrjänen, S. Solitary bronchial squamous cell papilloma – Another human papillomavirus (HPV)-associated benign tumor: systematic review and meta-analysis.  Contemp. Oncol. 17, 429-436, 2013 

Syrjänen, K. and Syrjänen, S. Detection of human papillomavirus (HPV) in sinonasal papillomas: systematic review and meta-analysis. Laryngoscope 123, 181-192, 2013.

Syrjänen, K. and Syrjänen, S. Detection of human papillomavirus (HPV) in sinonasal carcinoma: systematic review and meta-analysis. Hum. Pathol. 44, 983-991, 2013

Gama, R.R., Carvalho, A.L., Longatto Filho, A., Scorsato, A.P., Mendoza López, R.V., Rautava, J., Syrjänen, S. and Syrjänen, K. Detection of Human papillomavirus (HPV) in laryngeal squamous cell carcinoma (LSCC): Systematic review and meta-analysis. Laryngoscope 126, 885-893, 2016.