Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, University of Copenhagen, 2100, Copenhagen East, Denmark.
Department of Pathology, Rigshospitalet, University of Copenhagen, 2100, Copenhagen East, Denmark.
Eur J Cancer. 2020 Jul;134:52-59. doi: 10.1016/j.ejca.2020.04.027. Epub 2020 May 24.
The objectives of this study were to investigate the incidence of high-risk genotypes of human papillomavirus (HPV) in tumours of patients with oropharyngeal squamous cell carcinoma (OPSCC) during an 18-year period in Eastern Denmark.
In this population-based, consecutive, semi-national registry study, all patients diagnosed with OPSCC from 2000 to 2017 in Eastern Denmark were evaluated at head and neck oncological departments at public university hospitals. Analyses included tumour characteristics (HPV-positive [HPV+] versus HPV-negative [HPV-]), age-adjusted incidence rates (AAIRs), average annual percentage change (AAPC) of OPSCC, and patient demographics. All HPV+ cases from 2011 to 2017 were genotyped.
In total, 55% of 2169 OPSCC cases were HPV+. HPV16, HPV33, HPV35 or other types were found in 86%, 7.4%, 3.4% and 3.2% of cases, respectively. The AAIR per 100,000 of all OPSCCs was 1.8 in 2000, which increased to 5.1 in 2017 (HPV+: threefold increase, HPV-: twofold increase). The AAPC from 2000 to 2017 increased by 7% (HPV+ increased by 10% and HPV- by 4%). The median age at diagnosis for all OPSCC cases increased during the 18-year study period (HPV+: 58-61 years, p < 0.001; HPV-: 60-65 years, p < 0.001).
We report a threefold increase in OPSCC incidence during the 18-year observation period and a significant increase in median age at diagnosis. Over 93% of HPV genotypes in HPV+ OPSCC are included in current HPV vaccines except for HPV35 (4%). HPV vaccination of both sexes is advised to halt this emerging cancer epidemic.
本研究旨在调查丹麦东部地区 18 年间，口咽鳞状细胞癌（OPSCC）患者肿瘤中高危型人乳头瘤病毒（HPV）的发病率。
在这项基于人群的连续半国家注册研究中，评估了丹麦东部所有 2000 年至 2017 年间在公立大学医院头颈部肿瘤学部门诊断为 OPSCC 的患者。分析包括肿瘤特征（HPV 阳性[HPV+]与 HPV 阴性[HPV-]）、年龄调整发病率（AAIR）、OPSCC 的平均年百分比变化（AAPC）和患者人口统计学。对 2011 年至 2017 年所有 HPV+病例进行了基因分型。
2169 例 OPSCC 病例中，55%为 HPV+。HPV16、HPV33、HPV35 或其他类型分别占病例的 86%、7.4%、3.4%和 3.2%。2000 年所有 OPSCC 的 AAIR 为每 10 万人 1.8，到 2017 年增加到 5.1（HPV+：增加三倍，HPV-：增加两倍）。2000 年至 2017 年 AAPC 增加 7%（HPV+增加 10%，HPV-增加 4%）。所有 OPSCC 病例的中位诊断年龄在 18 年研究期间增加（HPV+：58-61 岁，p<0.001；HPV-：60-65 岁，p<0.001）。
我们报告了在 18 年观察期间 OPSCC 发病率增加了三倍，并且诊断中位年龄显著增加。HPV+OPSCC 中超过 93%的 HPV 基因型包括在当前的 HPV 疫苗中，除 HPV35（4%）外。建议男女接种 HPV 疫苗以阻止这种新出现的癌症流行。
