A systematic literature review of studies reporting human papillomavirus (HPV) prevalence in esophageal carcinoma over 36 years (1982-2017).

A total of 203 reports published between 1982 and 2017 on the association between human papillomaviruses (HPV) and esophageal squamous cell carcinoma (ESCC), originating from 187 studies performed in 32 countries from six continents, were selected and reviewed. The selected studies included a total of 14,788 ESCC cases; the presence of HPV infection was detected in 30.9% of cases (95% CI 30.1-31.6%) and was the highest in regions with the highest incidence of ESCC. Across studies published in the last 6 years, Alphapapillomavirus species were detected in 31.1% of ESCCs (1,464/4,708, 95% CI 29.8-32.4%), of which 73.8% (1,080/1,464, 95% CI 71.5-76.0%) were positive for the presence of HPV16/18. HPV16 was by far the most common HPV type detected, accounting for 21.0% (799.5/3,803, 95% CI 19.8-22.4%) of the total number of ESCC cases investigated. Our results are in line with previously published studies, suggesting the etiological role of HPV in the development of a subset of ESCC cases. Although the association between HPV and esophageal adenocarcinoma (EAC) has been studied to a far lesser extent, some studies also suggest a potential etiological role of HPV in a subset of EAC cases.