title: Prevalence of human papillomavirus in oropharyngeal and nonoropharyngeal head and neck cancer--systematic review and meta-analysis of trends by time and region.
abstract: BACKGROUND
  Little information has been reported on regional and time trends of human papillomavirus (HPV) prevalence rates of oropharyngeal cancer (OPC) and non-OPC.
  
  
  METHODS
  The study consisted of a systematic review and meta-analysis using random effects logistic regression models.
  
  
  RESULTS
  Overall HPV prevalence in OPC (47.7%; 95% confidence interval [CI], 42.9-52.5%) increased significantly over time: from 40.5% (95% CI, 35.1-46.1) before 2000, to 64.3% (95% CI, 56.7-71.3) between 2000 and 2004, and 72.2% (95% CI, 52.9-85.7) between 2005 and 2009 (p < .001). Prevalence increased significantly in North America and Europe, and the significant gap between them that existed before 2000 (50.7% vs 35.3%, respectively, p = .008) has now disappeared (69.7% vs 73.1%, respectively, p = .8). Prevalence in non-OPC (21.8%; 95% CI, 18.9-25.1%) has not increased over time (p = .97).
  
  
  CONCLUSIONS
  The sharp increase in the proportion of HPV-positive OPC over the last decade has occurred at a faster rate in Europe compared with that in North America. In contrast, the relatively low prevalence of HPV in non-OPC remains unchanged.
authors.affiliation: Institute of Head and Neck Studies and Education, Coventry, United Kingdom. Hisham.Mehanna@uhcw.nhs.uk
authors.forename: Hisham
authors.initials: H
authors.lastname: Mehanna
authors.forename: Tom
authors.initials: T
authors.lastname: Beech
authors.forename: Tom
authors.initials: T
authors.lastname: Nicholson
authors.forename: Iman
authors.initials: I
authors.lastname: El-Hariry
authors.forename: Christopher
authors.initials: C
authors.lastname: McConkey
authors.forename: Vinidh
authors.initials: V
authors.lastname: Paleri
authors.forename: Sally
authors.initials: S
authors.lastname: Roberts
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000821:virology*; D005060:Europe / Q000453:epidemiology; D006258:Head and Neck Neoplasms / Q000821:virology*; D006801:Humans; D016015:Logistic Models; D009656:North America; D009959:Oropharyngeal Neoplasms / Q000821:virology*; D030361:Papillomavirus Infections / Q000150:complications* / Q000453:epidemiology; D015995:Prevalence; D000077195:Squamous Cell Carcinoma of Head and Neck