Human papilloma virus testing in oral squamous cell carcinoma in Southern India: A case–control study

Abstract

Background: Oral cancer is a major public health burden in India ranking third among cancers; about 90% of all oral cancers are oral squamous cell carcinomas (OSCCs). Human papillomavirus (HPV) is a well-established oncogenic agent in the causation of cervical squamous cell carcinoma (SCC) and an important risk factor for oropharyngeal SCC, but the link between HPV and OSCC is inconsistent. Knowledge of HPV profile in the OSCC has positive implications for treatment and prevention strategies. Methods: A case–control study was conducted to determine the prevalence of HPV status in 40 newly diagnosed OSCC cases (24 males; 16 females). Age- and gender-matched controls were recruited from the outpatient clinic of a large teaching hospital in Southern India. A questionnaire was used to ascertain the risk factors for OSCC. Using a cytobrush, epithelial cells were obtained from oral cancer lesions or normal mucosa in cases and controls, respectively. The HPV detection and genotyping were done using a real-time polymerase chain reaction technique. Results: Chewing tobacco was strongly associated with OSCC (odds ratio: 3.6; 95% confidence interval: 1.4–9.7), adjusted for potential confounding factors including smoking and alcohol consumption. All the OSCC cases and controls tested negative for HPV DNA. Conclusions: There is an inconsistency in the prevalence of HPV infection in OSCC in India. The prevalence of HPV in OSCC was nil, so the testing for HPV may be unnecessary. The inconsistency of the positivity of HPV in OSCC may be due to a wide palette of geographic and sociocultural differences that exist in the subcontinent. Further studies are, therefore, needed to evaluate the prevalence of HPV in OSCC in the subcontinent and plan optimal therapeutic strategies.