title: Alcohol, smoking and human papillomavirus in laryngeal carcinoma: a Nordic prospective multicenter study.
abstract: OBJECTIVE
  Human papillomavirus (HPV) has been linked to oropharyngeal carcinomas, but its role in laryngeal squamous cell carcinoma (LSCC) is not clear. A prospective multicenter study based on known tumor-cell percentage of fresh frozen carcinoma biopsies was established to determine the HPV prevalence. Moreover risk factors such as smoking, alcohol abuse, chronic laryngitis and gastroesophageal reflux disease (GERD) were evaluated
  
  
  METHODS
  Fresh-frozen laryngeal cancer biopsies from 108 patients in Finland, Norway, and Sweden were investigated. Patients whose biopsy samples contained at least 20% tumor tissue (N = 69) entered the study. HPV DNA was determined with MY09/11 and GP5+/6+ nested PCR and SPF10 PCR hybridization assay. Patients were examined by an ENT specialist and an extensive questionnaire concerning risk factors was filled in.
  
  
  RESULTS
  Only three patients (4.4%) harbored HPV DNA in their carcinoma sample. Heavy alcohol drinking was associated with an increased risk of death, advanced-stage disease, and younger age at diagnosis. Chronic laryngitis, GERD, and orogenital sex contacts were rare. Poor oral hygiene was not associated with survival, although it correlated with heavy drinking.
  
  
  CONCLUSIONS
  In our series HPV was not important in LSCC. Heavy drinking led to major mortality in LSCC and promoted early carcinogenesis.
authors.affiliation: Department of Virology, Haartman Institute, University of Helsinki, Haartmaninkatu 3, P.O. Box 21, 00014 Helsinki, Finland. Walter.Koskinen@Helsinki.Fi
authors.forename: Walter J
authors.initials: WJ
authors.lastname: Koskinen
authors.forename: Kjell
authors.initials: K
authors.lastname: Brøndbo
authors.forename: Hanna
authors.initials: H
authors.lastname: Mellin Dahlstrand
authors.forename: Tapio
authors.initials: T
authors.lastname: Luostarinen
authors.forename: Timo
authors.initials: T
authors.lastname: Hakulinen
authors.forename: Ilmo
authors.initials: I
authors.lastname: Leivo
authors.forename: Anco
authors.initials: A
authors.lastname: Molijn
authors.forename: Wim G
authors.initials: WG
authors.lastname: Quint
authors.forename: Tov
authors.initials: T
authors.lastname: Røysland
authors.forename: Eva
authors.initials: E
authors.lastname: Munck-Wikland
authors.forename: Antti A
authors.initials: AA
authors.lastname: Mäkitie
authors.forename: Ilmari
authors.initials: I
authors.lastname: Pyykkö
authors.forename: Joakim
authors.initials: J
authors.lastname: Dillner
authors.forename: Antti
authors.initials: A
authors.lastname: Vaheri
authors.forename: Leena-Maija
authors.initials: LM
authors.lastname: Aaltonen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000428:Alcohol Drinking / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D004279:DNA, Viral; D005260:Female; D006801:Humans; D007822:Laryngeal Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D027383:Papillomaviridae; D030361:Papillomavirus Infections / Q000503:physiopathology*; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*
chemical_list: D004279:DNA, Viral