title: HPV-Related Oropharynx Cancer in the United Kingdom: An Evolution in the Understanding of Disease Etiology.
abstract: A rising incidence of oropharyngeal squamous cell carcinoma (OPSCC) incidence has occurred throughout the developed world, where it has been attributed to an increasing impact of human papillomavirus (HPV) on disease etiology. This report presents the findings of a multicenter cross-sectional retrospective study aimed at determining the proportion of HPV-positive and HPV-negative OPSCC within the United Kingdom. Archival tumor tissue blocks from 1,602 patients previously diagnosed with OPSCC (2002-2011) were collated from 11 centers. HPV status was determined with three validated commercial tests to provide valid data for 1,474 cases in total. Corresponding national incidence data from the same decade were obtained from UK Cancer registries. The overall proportion of HPV+OPSCC between 2002 and 2011 was 51.8% [95% confidence interval (CI), 49.3-54.4], and this remained unchanged throughout the decade [unadjusted RR = 1.00 (95% CI, 0.99-1.02)]. However, over the same period, the incidence of OPSCC in the broader UK population underwent a 2-fold increase [age-standardized rate 2002: 2.1 (95% CI, 1.9-2.2); 2011: 4.1 (95% CI, 4.0-4.3)]. Although the number of OPSCCs diagnosed within the United Kingdom from 2002 to 2011 nearly doubled, the proportion of HPV+cases remained static at approximately 50%. Our results argue that the rapidly increasing incidence of OPSCC in the United Kingdom cannot be solely attributable to the influence of HPV. The parallel increase in HPV+and HPV-cases we documented warrants further investigation, so that appropriate future prevention strategies for both types of disease can be implemented. Cancer Res; 76(22); 6598-606. ©2016 AACR.
authors: Department of Molecular & Clinical Cancer Medicine, Northwest Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom.|Head & Neck Unit, University Hospital Aintree, Liverpool, United Kingdom.
authors: Andrew G
authors: AG
authors: Schache
authors: Institute of Cancer and Genetics, Cardiff University School of Medicine, Cardiff, United Kingdom.
authors: Ned G
authors: NG
authors: Powell
authors: Scottish Human Papillomavirus Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors: Kate S
authors: KS
authors: Cuschieri
authors: Centre for Oral Health Research, Newcastle University, Newcastle, United Kingdom.
authors: Max
authors: M
authors: Robinson
authors: Biomedical Research Unit in Nutrition, Diet and Lifestyle, School of Oral and Dental Sciences, University Hospitals Bristol, Bristol, United Kingdom.
authors: Sam
authors: S
authors: Leary
authors: Institute of Head and Neck Studies and Education (InHANSE), College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom.
authors: Hisham
authors: H
authors: Mehanna
authors: Brazilian National Cancer Institute, Rio de Janeiro, Brazil.
authors: Davy
authors: D
authors: Rapozo
authors: Cellular Pathology, Newcastle-upon-Tyne Hospitals NHS Foundation Trust, Newcastle, United Kingdom.
authors: Anna
authors: A
authors: Long
authors: Scottish Human Papillomavirus Reference Laboratory, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors: Heather
authors: H
authors: Cubie
authors: Edinburgh Cancer Research Centre, Institute of Genetics and Molecular Medicine, University of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors: Elizabeth
authors: E
authors: Junor
authors: Pathology Department, Royal Infirmary of Edinburgh, Edinburgh, Scotland, United Kingdom.
authors: Hannah
authors: H
authors: Monaghan
authors: NIHR Biomedical Research Centre, The Institute of Cancer Research, London, United Kingdom.|Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors: Kevin J
authors: KJ
authors: Harrington
authors: Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors: Christopher M
authors: CM
authors: Nutting
authors: NIHR Biomedical Research Centre, The Institute of Cancer Research, London, United Kingdom.|Royal Marsden NHS Foundation Trust, London, United Kingdom.
authors: Ulrike
authors: U
authors: Schick
authors: Department of Molecular & Clinical Cancer Medicine, Northwest Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom.|Head & Neck Unit, University Hospital Aintree, Liverpool, United Kingdom.
authors: Andy S
authors: AS
authors: Lau
authors: Department of Molecular & Clinical Cancer Medicine, Northwest Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom.|Head & Neck Unit, University Hospital Aintree, Liverpool, United Kingdom.
authors: Navdeep
authors: N
authors: Upile
authors: Pathology Department, Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom.
authors: Jon
authors: J
authors: Sheard
authors: Pathology Department, Aintree University Hospital NHS Foundation Trust, Liverpool, United Kingdom.
authors: Kath
authors: K
authors: Brougham
authors: Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom.
authors: Catharine M L
authors: CM
authors: West
authors: Institute of Cancer Sciences, University of Manchester, Manchester, United Kingdom.
authors: Ken
authors: K
authors: Oguejiofor
authors: School of Oral & Dental Sciences, University of Bristol, Bristol, United Kingdom.
authors: Steve
authors: S
authors: Thomas
authors: Biomedical Research Unit in Nutrition, Diet and Lifestyle, School of Oral and Dental Sciences, University Hospitals Bristol, Bristol, United Kingdom.
authors: Andy R
authors: AR
authors: Ness
authors: School of Oral & Dental Sciences, University of Bristol, Bristol, United Kingdom.
authors: Miranda
authors: M
authors: Pring
authors: Cancer Sciences Unit, University of Southampton, Southampton, United Kingdom.
authors: Gareth J
authors: GJ
authors: Thomas
authors: Poole Hospital NHS Foundation Trust, Poole, United Kingdom.
authors: Emma V
authors: EV
authors: King
authors: Department of Pathology, School of Medicine, University of New Mexico, Albuquerque, New Mexico.
authors: Dennis J
authors: DJ
authors: McCance
authors: Northern Ireland Molecular Pathology Laboratory, Centre for Cancer Research and Cell Biology, Belfast, Northern Ireland.
authors: Jacqueline A
authors: JA
authors: James
authors: Royal Victoria Hospital, Belfast, Northern Ireland.
authors: Michael
authors: M
authors: Moran
authors: Centre for Oral Health Research, Newcastle University, Newcastle, United Kingdom.
authors: Phil
authors: P
authors: Sloan
authors: Department of Molecular & Clinical Cancer Medicine, Northwest Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom.|Head & Neck Unit, University Hospital Aintree, Liverpool, United Kingdom.
authors: Richard J
authors: RJ
authors: Shaw
authors: Velindre Cancer Centre, Cardiff, United Kingdom.
authors: Mererid
authors: M
authors: Evans
authors: Department of Molecular & Clinical Cancer Medicine, Northwest Cancer Research Centre, University of Liverpool, Liverpool, United Kingdom. T.M.Jones@liverpool.ac.uk.|Head & Neck Unit, University Hospital Aintree, Liverpool, United Kingdom.
authors: Terry M
authors: TM
authors: Jones
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D009959:Oropharyngeal Neoplasms / Q000209:etiology* / Q000821:virology; D027383:Papillomaviridae / Q000235:genetics*; D030361:Papillomavirus Infections / Q000821:virology*; D006113:United Kingdom