Prevalence of human papillomavirus antibodies and survival in people with head and neck cancer: Results from head and neck 5000

Introduction:

Human papillomavirus (HPV) is associated with survival in oropharyngeal cancer (OPC). We describe the prevalence of HPV antibodies and differences in survival in head and neck 5000, a prospective clinical cohort of 5,369 people diagnosed with head and neck cancer (HNC) in the UK from 2011 to 2014.

Methods:

Prior to treatment, participants completed questions on smoking and provided a blood sample. Clinical and treatment information were extracted from clinical notes. Site was coded using clinical or pathology records. Blood samples were analysed using multiplex serology. HPV seropositivity was based on antibody response to HPV16 E6, other HPV16 early proteins and to early proteins from other HPV types. Date of death was obtained through record linkage. People who did not have squamous cell carcinoma were excluded. Cox regression models included age, gender, stage (not for primary of unknown origin, PUO), treatment intent, smoking and co-morbidity.

Results:

The prevalence of HPV seropositivity was 72.5% in 1,583 people with OPC; 59.7% in 129 people with PUO; 10.0% in 321 people with nasophayngeal, hypopharyngeal and nasal cavity cancer – medium prevalence group(MPG) and 3.2% in 2,009 people with oral cavity, laryngeal, sinus and salivary gland cancer – low prevalence group (LPG). Adjusted hazard ratios for overall survival were 0.39 (95% CI 0.27 to 0.56) for OPC; 0.17 (95% CI 0.03 to 1.00) for PUO; 0.32 (95% CI 0.11 to 0.98) for the MPG and 0.59 (95% CI 0.29 to 1.21) for the LPG.

Conclusions:

The prevalence of HPV seropositivity in the UK is high in people with OPC and PUO. People with HPV positive OPC have better survival. There is a suggestion that HPV seropositive people with PUO and MPG tumours also have improved survival.

Publication History

Publication Date:
18 April 2018 (online)