Abstract
Background. Human papillomavirus (HPV) infection has been recognized as an important risk factor in cancer. The purpose of this systematic review and meta-analysis was to determine the prevalence and effect size of association between salivary HPV DNA and the risk of developing oral and oropharyngeal cancer. Methods. A systematic literature search of PubMed, EMBASE, Web of Science, LILACS, Scopus and the Cochrane Library was performed, without language restrictions or specified start date. Pooled data were analyzed by calculating odds ratios (ORs) and 95% confidence intervals (CIs). Quality assessment was performed using the Newcastle–Ottawa Scale (NOS). Results. A total of 1672 studies were screened and 14 met inclusion criteria for the meta-analysis. The overall prevalence of salivary HPV DNA for oral and oropharyngeal carcinoma was 43.2%, and the prevalence of salivary HPV16 genotype was 27.5%. Pooled results showed a significant association between salivary HPV and oral and oropharyngeal cancer (OR = 4.94; 2.82−8.67), oral cancer (OR = 2.58; 1.67−3.99) and oropharyngeal cancer (OR = 17.71; 6.42−48.84). Significant associations were also found between salivary HPV16 and oral and oropharyngeal cancer (OR = 10.07; 3.65−27.82), oral cancer (OR = 2.95; 1.23−7.08) and oropharyngeal cancer (OR = 38.50; 22.43−66.07). Conclusions. Our meta-analysis demonstrated the association between salivary HPV infection and the incidence of oral and oropharyngeal cancer indicating its value as a predictive indicator.
Highlights
Human papillomavirus (HPV) infection has been recognized as an important risk factor in a subset of head and neck squamous cell carcinomas, independently of traditional risk factors such as tobacco or alcohol use [1,2]
The following information was extracted from each study: author, publication year, country, type of sample, method of collection, tumor location, sample size, HPV detection method, number of cases and HPV-positive cases, number of controls and HPV-positive controls, HPV-positive genotypes, overall HPV DNA prevalence and type-specific HPV DNA prevalence
The pooled analysis showed a significant association between positive salivary HPV DNA status and oral and oropharyngeal cancer with a pooled odds ratios (ORs) of 4.94 (Figure 3)
Summary
Human papillomavirus (HPV) infection has been recognized as an important risk factor in a subset of head and neck squamous cell carcinomas, independently of traditional risk factors such as tobacco or alcohol use [1,2]. The collection of oral exfoliated cells with cotton swabs or cytobrush is restricted to a specific and accessible oral area, making collection difficult for non-visual tumors and early molecular alterations To overcome these drawbacks, the detection of HPV in oral exfoliated cells from saliva (with or without oral rinses) represents a quick and easy non-invasive alternative for oral and oropharyngeal cancer screening in high-risk populations. The detection of HPV in oral exfoliated cells from saliva (with or without oral rinses) represents a quick and easy non-invasive alternative for oral and oropharyngeal cancer screening in high-risk populations In this sense, several researchers have analyzed the prevalence of salivary HPV DNA from head and neck cancer, to our knowledge, no previous systematic review has elucidated evidence of this relationship. The aim of the present systematic review and meta-analysis was to determine the prevalence and effect size of association between salivary HPV DNA and the risk of developing oral and oropharyngeal cancer
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