Claudie Laprise1, Sreenath Arekunnath Madathil2, Nicolas F Schlecht3, Geneviève Castonguay4, Denis Soulières5, Phuc Felix Nguyen-Tan6, Paul Allison4, François Coutlée7, Michael Hier8, Marie-Claude Rousseau2, Eduardo L Franco9, Belinda Nicolau10. 1. Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada; Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada. 2. Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada; Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, Laval, Quebec, Canada. 3. Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, United States. 4. Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada. 5. Department of Hemato-Oncology, Hôpital Notre-Dame du Centre Hospitalier de I'Université de Montréal, Montreal, Canada. 6. Department of Radiation Oncology, Hôpital Notre-Dame du Centre Hospitalier de I'Université de Montréal, Montreal, Canada. 7. Department of Microbiology and Infectious Diseases, Hôpital Notre-Dame du Centre de Recherche du Centre Hospitalier de I'Université de Montréal, Montreal, Quebec, Canada. 8. Faculty of Medicine, McGill University, Department of Otolaryngology-Head and Neck Surgery, Montreal, Quebec, Canada. 9. Division of Cancer Epidemiology, McGill University, Montreal, Quebec, Canada. 10. Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Canada. Electronic address: belinda.nicolau@mcgill.ca.
Abstract
OBJECTIVE: Human papillomaviruses (HPV) are changing dramatically the epidemiologic landscape of head and neck cancers (HNCs). Their role in the aetiology of these cancers varies widely among HNCs subsites, sex and geographical regions worldwide. We describe HPV prevalence and its association with HNCs risk overall and by anatomical subsite in a sample of Canadians. MATERIALS AND METHODS: The HeNCe Life study recruited 460 incident HNCs cases and 458 controls frequency-matched by age and sex from four Montreal hospitals in 2005-2013. We tested oral rinse and oral brush specimens for mucosal HPV genotypes. HPV positivity was categorized hierarchically as either negative, exclusively non-α-9 species types, α-9 types other than HPV16, and HPV16. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the associations between HPV and HNCs using unconditional logistic regression, controlling for confounders. RESULTS: The prevalence of HPV infection among controls and cases was 14.5% and 41.2% in oral rinse and 3.1% and 24.4% in oral brush samples, respectively. HPV16 was the predominant genotype with an oral rinse and oral brush prevalence of 26.3% and 16.2% among cases and 2.4% and 0.2% among controls, respectively. HPV infection was associated with an increased risk of HNCs overall (OR=4.18; 95% CI, 2.94-5.95) and oropharyngeal cancer only (OR=10.3; 95% CI, 6.8-15.7). HNCs and oropharyngeal cancer were strongly associated with HPV16 (OR=18.1; 95% CI, 9.1-35.8, and OR=47.2; 95% CI, 23.1-96.6, respectively). CONCLUSION: HPV infection, particularly HPV16, was associated with an increased HNCs risk, most strongly for oropharyngeal cancers.
OBJECTIVE: Human papillomaviruses (HPV) are changing dramatically the epidemiologic landscape of head and neck cancers (HNCs). Their role in the aetiology of these cancers varies widely among HNCs subsites, sex and geographical regions worldwide. We describe HPV prevalence and its association with HNCs risk overall and by anatomical subsite in a sample of Canadians. MATERIALS AND METHODS: The HeNCe Life study recruited 460 incident HNCs cases and 458 controls frequency-matched by age and sex from four Montreal hospitals in 2005-2013. We tested oral rinse and oral brush specimens for mucosal HPV genotypes. HPV positivity was categorized hierarchically as either negative, exclusively non-α-9 species types, α-9 types other than HPV16, and HPV16. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the associations between HPV and HNCs using unconditional logistic regression, controlling for confounders. RESULTS: The prevalence of HPV infection among controls and cases was 14.5% and 41.2% in oral rinse and 3.1% and 24.4% in oral brush samples, respectively. HPV16 was the predominant genotype with an oral rinse and oral brush prevalence of 26.3% and 16.2% among cases and 2.4% and 0.2% among controls, respectively. HPV infection was associated with an increased risk of HNCs overall (OR=4.18; 95% CI, 2.94-5.95) and oropharyngeal cancer only (OR=10.3; 95% CI, 6.8-15.7). HNCs and oropharyngeal cancer were strongly associated with HPV16 (OR=18.1; 95% CI, 9.1-35.8, and OR=47.2; 95% CI, 23.1-96.6, respectively). CONCLUSION:HPV infection, particularly HPV16, was associated with an increased HNCs risk, most strongly for oropharyngeal cancers.
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