Evolving Profile of HPV-Driven Oropharyngeal Squamous Cell Carcinoma in a National Cancer Institute in Italy: A 10-Year Retrospective Study.

Maria Gabriella Donà,Raul Pellini,Francesca Rollo,Maria Benevolo,Giuseppe Spriano,Renato Covello,Barbara Pichi,Silvia Moretto

doi:10.3390/microorganisms8101498

Abstract

Globally, 30% of oropharyngeal carcinomas (OPSCC) are caused by Human Papillomavirus (HPV). Recently, increasing incidence trends for HPV-driven OPSCC have been reported in many countries and changes in the typical HPV-positive OPSCC patient have been recorded, with an increase in the median age and diagnoses in women. We investigated the characteristics of the OPSCC patients attending an Italian Cancer Institute from 2010 to 2019 and assessed possible changes overtime of demographic, behavioral, and clinico-pathologic variables of HPV-driven OPSCC. Overall, 339 OPSCCs were evaluated. HPV-DNA and p16 positivity were 48.7% and 55.2%, respectively, with an HPV-driven fraction (i.e., HPV-DNA+/p16+) of 48.3%. We observed a significant increase overtime in the rate of HPV-associated cases (53.7% in 2015–2019 vs. 40.3% in 2010–2014, p = 0.019). The rate of HPV-driven cases was significantly higher among women, never smokers, patients with T1–T2 tumors, and with nodal involvement. A trend was also observed toward an increase in HPV-driven OPSCCs among patients >61 years, women, former smokers, and patients with no nodal involvement in 2015–2019. Our findings consolidate the observation that HPV-associated OPSCCs are also increasing in Italy. Moreover, they suggest that the profile of the HPV-driven OPSCC patient might be changing.

Highlights

Head and neck squamous cell carcinomas represent the sixth most common malignancy by incidence worldwide and are mostly caused by tobacco and alcohol consumption [1]
We investigated the characteristics of the OPSCC patients attending an Italian Cancer Institute from 2010 to 2019 and assessed possible changes overtime of demographic, behavioral, and clinico-pathologic variables of Human Papillomavirus (HPV)-driven OPSCC
Due to the emerging data regarding a change in the HPV-attributable fraction and in the epidemiologic profile of OPSCC patients in developed countries, we aimed to evaluate whether similar modifications are occurring in an Italian population sample

Summary

Introduction

Head and neck squamous cell carcinomas represent the sixth most common malignancy by incidence worldwide and are mostly caused by tobacco and alcohol consumption [1]. A significant geographic variation in the HPV-attributable fraction exists, with the highest prevalence found in North America, Northern and Central Europe [3,4,5] Despite this heterogeneity, HPV16, which has been recognized as a causative agent of OPSCC by the International Agency for Research on Cancer (IARC) [6], represents the most prevalent genotype in HPV-related OPSCCs worldwide. HPV-negative and -positive OPSCCs present distinct epidemiologic profiles, especially regarding age at onset and association with tobacco and alcohol consumption [9]. They differ in terms of pathologic features (e.g., tumor size and nodal involvement). Detection of HPV-DNA, in combination with p16 and/or HPV-mRNA evaluation, represents one of the most reliable diagnostic approaches for the identification of HPV-driven OPSCCs [17]

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