title: Human papillomavirus genotype and oropharynx cancer survival in the United States of America.
abstract: BACKGROUND
  The presence of human papillomavirus (HPV) DNA in oropharyngeal squamous cell cancer (OPSCC) tissue appears to be a strong predictor of improved prognosis, but this observation has not been explored in a population-based sample with generalisable findings.
  
  
  METHODS
  Follow-up data from a large sample of OPSCC patients identified through six population-based cancer registries in the United States of America (USA) were used to characterise the association of tumour HPV status with survival.
  
  
  RESULTS
  HPV DNA was detected in tumour tissue from 71% (378 in 529) of the OPSCC patients. A total of 65% of patients with HPV16-associated tumours survived 5 years compared to 46% of patients with other HPV types and 28% of patients with HPV-negative tumours (p log-rank test <0.0001). The OPSCC patients with detectable HPV16 DNA had a 62% reduced hazard of death at 5 years, and patients with other HPV types had a 42% reduced hazard of death at 5 years compared to HPV-negative patients. Compared to non-Hispanic Whites, Blacks with OPSCC had a 2.6-fold greater risk of death at 5 years after adjustment for HPV status and other prognostic variables. Both surgery and radiation therapy were associated with a reduced 5-year risk of death, but no evidence was found for an interaction between HPV status and radiotherapy or surgery on survival time.
  
  
  CONCLUSIONS
  Data from this US study suggest that HPV16-positive OPSCC patients survive longer than HPV-negative patients regardless of treatment, highlighting the prognostic importance of HPV status for this malignancy. Optimal treatment regimens for OPSCC could be tailored to each patient's HPV status and prognostic profile.
authors.affiliation: Cancer Prevention and Control Program, Samuel Oschin Comprehensive Cancer Institute, Cedars-Sinai Medical Center, Los Angeles, CA, USA. Electronic address: marc.goodman@cshs.org.
authors.forename: Marc T
authors.initials: MT
authors.lastname: Goodman
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: msaraiya@cdc.gov.
authors.forename: Mona
authors.initials: M
authors.lastname: Saraiya
authors.affiliation: Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Trevor D
authors.initials: TD
authors.lastname: Thompson
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Martin
authors.initials: M
authors.lastname: Steinau
authors.affiliation: University of Hawaii Cancer Center, University of Hawaii, Honolulu, HI, USA.
authors.forename: Brenda Y
authors.initials: BY
authors.lastname: Hernandez
authors.affiliation: Department of Epidemiology, College of Public Health, The University of Iowa, Iowa City, IA, USA.
authors.forename: Charles F
authors.initials: CF
authors.lastname: Lynch
authors.affiliation: Battelle Memorial Institute, Durham, NC, USA.
authors.forename: Christopher W
authors.initials: CW
authors.lastname: Lyu
authors.affiliation: Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL, USA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Wilkinson
authors.affiliation: Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, KY, USA.
authors.forename: Thomas
authors.initials: T
authors.lastname: Tucker
authors.affiliation: Michigan Department of Community Health, Lansing, MI, USA.
authors.forename: Glenn
authors.initials: G
authors.lastname: Copeland
authors.affiliation: Department of Epidemiology, School of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
authors.forename: Edward S
authors.initials: ES
authors.lastname: Peters
authors.affiliation: Division of Cancer Control and Population Sciences, National Cancer Institute, Rockville, MD, USA.
authors.forename: Sean
authors.initials: S
authors.lastname: Altekruse
authors.affiliation: Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
authors.forename: Elizabeth R
authors.initials: ER
authors.lastname: Unger
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000628:therapy / Q000821:virology*; D004279:DNA, Viral / Q000235:genetics*; D005260:Female; D005838:Genotype; D006258:Head and Neck Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000628:therapy / Q000821:virology*; D061809:Human Papillomavirus DNA Tests; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009959:Oropharyngeal Neoplasms / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000628:therapy / Q000821:virology*; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000175:diagnosis / Q000208:ethnology / Q000401:mortality / Q000821:virology*; D016016:Proportional Hazards Models; D044469:Racial Groups; D012307:Risk Factors; D018426:SEER Program; D000077195:Squamous Cell Carcinoma of Head and Neck; D013997:Time Factors; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology
chemical_list: D004279:DNA, Viral
keywords: Archived tissue; Cancer of the oropharynx; Cancer registry; Human papillomavirus; Survival