Strong association between infection with human papillomavirus and oral and oropharyngeal squamous cell carcinoma: A population-based case-control study in southern Sweden

• Published in: Acta oto-laryngologica Vol. 125; no. 12; pp. 1337 - 1344
• Main Authors: Hansson, Bengt Göran, Rosenquist, Kerstin, Antonsson, Annika, Wennerberg, Johan, Schildt, Elsy-Britt, Bladström, Anna, Andersson, Gunilla
• Format: Journal Article
• Language: English
• Published: Stockholm Informa UK Ltd 2005; Taylor & Francis; Taylor and Francis
• Subjects: Adult; Age Distribution; Aged; Aged, 80 and over; Attributable proportion; Biological and medical sciences; Carcinoma, Squamous Cell - epidemiology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - virology; Case-Control Studies; Clinical Medicine; Comorbidity; DNA, Viral - analysis; Female; Human papillomavirus; human papillomavirus DNA; Humans; Incidence; International Classification of Diseases code; Klinisk medicin; Male; Medical and Health Sciences; Medical sciences; Medicin och hälsovetenskap; Middle Aged; Mouth Neoplasms - epidemiology; Mouth Neoplasms - pathology; Mouth Neoplasms - virology; mouthwash; Neoplasm Staging; oral and oropharyngeal squamous cell carcinoma; Oropharyngeal Neoplasms - epidemiology; Oropharyngeal Neoplasms - pathology; Oropharyngeal Neoplasms - virology; Oto-rhino-laryngologi; Otorhinolaryngology; Otorhinolaryngology. Stomatology; Papillomaviridae - isolation & purification; Papillomavirus Infections - diagnosis; Papillomavirus Infections - epidemiology; Polymerase Chain Reaction; Precancerous Conditions - pathology; Reference Values; Risk Assessment; risk factor; Sex Distribution; Survival Analysis; Sweden - epidemiology; Tumors; Upper respiratory tract, upper alimentary tract, paranasal sinuses, salivary glands: diseases, semeiology; Sweden; Europe; Human; mouthwash; Papovaviridae; Malignant tumor; Case control study; oral and oropharyngeal squamous cell carcinoma; Papillomavirus; Virus; Infection; Oropharynx squamous cell carcinoma; Human papillomavirus; Attributable proportion; DNA; Classification; Risk factor; ENT disease; Pharynx disease; International Classification of Diseases code; human papillomavirus DNA
• ISSN: 0001-6489; 1651-2251; 1651-2251
• DOI: 10.1080/00016480510043945

Conclusions. The results of this study demonstrate a strong association between infection with high-risk types of human papillomavirus (HPV) and oral and oropharyngeal squamous cell carcinoma (OOSCC), suggesting that high-risk HPV types play a key role in carcinogenesis. The estimated proportion of OOSCC cases attributable to HPV infection was 35%. Objective. HPV appears to have an aetiological role in OOSCC, despite the fact that the reported prevalences of HPV in both OOSCC patients and healthy individuals have varied widely. We aimed to investigate the presence and spectrum of both high- and low-risk HPVs in all consecutive cases of OOSCC in a Swedish healthcare region over a 3-year period and in population-based, matched healthy controls. Material and methods. A total of 131 patients with OOSCC were studied. Samples taken from the surface of the tumour and from the tonsillar fossa using cotton-tipped swabs were investigated, together with exfoliated cells collected using a mouthwash. Tonsillar fossa and mouthwash specimens were collected in the same way from 320 matched controls. All samples were tested for HPV DNA by nested polymerase chain reaction using the primer pairs MY09/MY11 and GP5 + /GP6+, and in positive cases the HPV type was determined by DNA sequencing. Results. Infection with high-risk HPV was shown to be a strong risk factor for OOSCC (OR = 63; 95% CI 14-480). Forty-seven (36%) of the cancer patients had ≥1 specimen that was positive for a high-risk HPV type (81% of which were HPV 16), while only 3 (0.94%) of the controls were positive for a high-risk HPV type. Seven (5.3%) of the cancer patients and 13 (4.1%) of the controls were positive for any of the mucosal, mucocutaneous or cutaneous low-risk HPV types.