Genotypes and Prevalence of High-Risk Human Papillomavirus Among Patients Diagnosed With Head and Neck Cancer at Alexandria Cancer Centre

Abstract

PURPOSE The purpose of this study was to provide original data on the prevalence of head and neck cancer (HNC) and high-risk human papillomavirus (HPV) genotypes among patients diagnosed with HNC in Kenya. Globocan 2018 findings indicate that cervical cancer is the second most frequent cancer in women in East Africa, which suggests a high prevalence of oncogenic HPV among the general population in this region. METHODS This was a retrospective study with laboratory analysis involving histologically confirmed head and neck tissue samples between January 2017 and December 2018. Stored tissues were retrieved and subjected to repeat microscopy, p16 immunohistochemistry, and HPV polymerase chain reaction at the Pathologists Lancet Group of Laboratories. Data were analyzed using descriptive statistics with Excel. RESULTS HNC accounted for 8.8% of all malignancies at Alexandria Cancer and Palliative Care Hospital. There were more males (64%) than females (36%). Mean age was 50.9 years (± 17.6 years). Most patients came from the western Kenya region. Approximately one third (35.7%) of participants were farmers and students combined. The following were most common subsites identified: nasopharynx (n = 25), larynx (n = 12), and tongue (n = 10); 93.5% were squamous cell carcinoma. Sixteen samples (55.2%) tested p16 positive, of these 2 (12.5%) tested positive with HPV polymerase chain reaction. One of these was from an 87-year-old female who was diagnosed with tongue cancer. Molecular analysis revealed the genotype to be HPV52, and the other was from a 49-year-old male with cancer of the postnasal space who had multiple coinfection with HPV35, -52, and -59 genotypes. CONCLUSION HNC represented 8.8% of the malignancies at Alexandria Cancer and Palliative Care Hospital; 55.2% tested p16 positive and the study managed to detect 3 high-risk HPV genotypes, HPV35, HPV52, and HPV59.