The demography of human papillomavirus (HPV) infections in oropharyngeal cancer patients from 2011-2016: A single Veteran Administration institution.

Abstract

e17532 Background: Human papilloma virus (HPV) is a known biologic (viral) carcinogen and has a predilection for tissue in head and neck sites- HPV types 16/18. Current NCCN guidelines recommend HPV testing on newly diagnosed cancers - Head and Neck region - specifically the oropharynx. Methods: After IRB approval, data from our center ranging from 01/01/2011 to 12/31/2016 were collected by using international classification codes (ICD-9) 142, 143, and 146. We enrolled 81 patients for review from of these anatomic sites: Base of tongue, Tonsils, Posterior hypo-pharyngeal wall, soft palate and unknown primary + neck nodes. Data collected: HPV status / age / stage at diagnosis. Risk factors collected were marital status, ethnicity, age, alcohol and tobacco use, and other co-factors. Results: A total of 73 of 81 cases met our criteria for inclusion into review: excluded - 5 with Non-Hodgkin’s lymphoma; 1 with plasma cell neoplasm; 2 excluded - p16 testing only. All enrollees were male. Age range 45 - 91. Mean age: HPV + 64.11 / HPV – 66.76yrs. Anatomic site:BOT-35(48%) /Tonsil-25 (34%) /unknown primacy- 6(8%) /Soft palate– 4(0.05%) /Hypo-pharnyx-3(0.04%). Ethnicity: Non-Hispanic White– 32(44%) /Black-19(26%) /Hispanic – 20 (27%) /American Indian – 1(0.01%) /Unknown – 0. Seventy-three tested for HPV: 36 pos (49%) /37 neg (51% ). Whites were of 49% HPV+. HPV16/18+ in 34 of 36 (94%) tumors. Tobacco exposure ever:32/37(75%) HPV + and 26/36 (75%) HPV - groups. Alcohol use ever: HPV+ 75%; HPV – 67%. Location:BOT/Tonsils were 32/36 (80%) HPV+ cases and 27/37(73%) of HPV – cases. HPV + Marital status: Married 9 (26%) / Never mar 9/Divced 15/Sep 2/Wid 1 - 74% not married. HPV – 37: Married 12 (32%) /Never mar 9 /Divced 9/Sep 5/Wid 2 – 68% not married. Conclusions: HPV +16/18 (34 of 36) infections in our patients (73) were 49% of the overall group. BOT and Tonsil cancers most were the common sites in both groups (+/-). Compared to non-VA patients, our HPV + group used more alcohol and smoked more, and were older - though both groups (+/-) had high usage rates. We noted more divorcees, and lower marriage rate in the HPV+ group. Whites were 44% overall but 49% of HPV + group.