Human Papillomavirus–Associated Head and Neck Cancer in Hong Kong

Abstract

Objectives: Human papillomaviruses (HPV) are a well-documented cause of a subset of head and neck cancer. Studies have shown the prevalence of HPV infection is around 7% in the general US population. Yet data from an Asian population and analysis from different head and neck subsites are sparse. In this retrospective case control study, we systematically reviewed data from subjects diagnosed with squamous cell carcinoma of the oral cavity, oropharynx, larynx, and hypopharynx in Chinese patients at Yan Chai Hospital. Methods: Surgical specimens or biopsies were prospectively sent for detection of HPV DNA by polymerase chain reaction and immunohistochemical staining for p16 and p53. Results: In the 110 specimens obtained, preliminary results showed the overall prevalence of HPV was 21%. HPV 16 accounted for the majority of HPV-positive oropharyngeal squamous cell carcinoma (SCC; 85%) and laryngeal SCC (66%). Other oncogenic HPVs, apart from HPV16 and 18, were rarely detected in our series. In the multiple logistic regression analysis, HPV-associated oropharyngeal and oral cavity patients showed better overall survival, but this was statistically insignificant for laryngeal and hypopharyngeal patients. HPV positive and negative patients showed no statistically significant difference in disease staging on presentation as well as treatment modalities. Conclusions: The prevalence of HPV associated head and neck cancer is much lower in Hong Kong Chinese. Our overall survival of HPV associated oropharyngeal and laryngeal cancer showed consistent favorable outcomes compared with those of other western countries.