The emerging risk of oropharyngeal and oral cavity cancer in HPV-related subsites in young people in Brazil.

Fabrício dos Santos Menezes,Maria do Rosário Dias de Oliveira Latorre,José Leopoldo Ferreira Antunes,Maria Paula Curado,Gleice Margarete de Souza Conceição,Tatiana Natasha Toporcov,Xuefeng Liu

doi:10.1371/journal.pone.0232871

Fabrício dos Santos Menezes, Maria do Rosário Dias de Oliveira Latorre + Show 5 more

Open Access

https://doi.org/10.1371/journal.pone.0232871

Copy DOI

Abstract

Human papillomavirus (HPV) is responsible for the rise in the incidence of cancer in the oropharynx, tonsils, and base of the tongue (i.e., HPV-related subsites). HPV triggered the changes in the epidemiology of oropharyngeal and oral cavity cancer (OPC/OCC) in Asia, Europe, North America, and Oceania. Hence, the incidence of cancer in HPV-related subsites is augmenting, while that in other HPV-unrelated subsites is decreasing. In South America, although the incidence of HPV-positive tumors has gradually increased, there is an atypically low prevalence of HPV in people with OPC/OCC. To clarify whether this dramatic shift in incidence trends also occurred in this population, we estimated the burden of HPV on the incidence trends of OPCs/OCCs in São Paulo city in Brazil. In this population-based study, we categorized OPCs/OCCs by HPV-related and HPV-unrelated subsites. We used Poisson regression to assess the age-standardized incidence rates (ASRs) stratified by sex and age groups, as well as to examine the age-period-cohort effects. There were 15,391 cases of OPCs/OCCs diagnosed in HPV-related (n = 5,898; 38.3%) and HPV-unrelated (n = 9,493; 61.7%) subsites. Overall, the ASRs decreased for most subsites, for both sexes and for all age groups, except for HPV-related OPC/OCC in young males and females, which increased by 3.8% and 8.6% per year, respectively. In the birth-cohort-effect analysis, we identified an increasing risk for HPV-related OPC/OCC in both sexes in recent birth cohorts; however, this risk was sharply decreased in HPV-unrelated subsites. Our data demonstrate an emerging risk for HPV-related OPC/OCC in young people, which supports prophylactic HPV vaccination in this group.

Highlights

Human papillomavirus (HPV) is an oncogenic virus that is sexually transmitted, and it is the cause of an estimated 630,000 new cancers each year worldwide [1]
We found a dramatic increase in incidence for HPV-related subsites in young males and females, by 3.8% and 8.6% per year, respectively; in contrast, HPV-unrelated subsites had a decreased incidence rate for most sexes and age groups (Fig 1)
We performed this study to determine the burden of HPV in OPC/OCC in São Paulo city, which is the largest city in Latin America

Summary

Introduction

Human papillomavirus (HPV) is an oncogenic virus that is sexually transmitted, and it is the cause of an estimated 630,000 new cancers each year worldwide [1]. There is a causal association between HPV and oropharyngeal and oral cavity cancers (OPCs/OCCs) [2]. In addition to the unique carcinogenesis pathway [3] and HPV DNA identified in tumors [4], HPV-positive OPCs/OCCs are associated with clinical and epidemiological features, such as a young age at diagnosis, high-risk sexual behaviors [5,6], and enhanced survival rates [7], which distinguish these cancers from their HPV-negative counterparts. Patients from a private hospital had an HPV positivity rate of 59.1% [21], which demonstrates the HPV heterogeneity in the country Due to these discrepancies in the prevalence of HPV, it is crucial to monitor these subsites to clarify whether this dramatic shift in incidence trends observed worldwide affects this population

Methods

Results

Conclusion