Department of Otolaryngology - Head and Neck Surgery, AdventHealth Orlando, 410 Celebration Place, Celebration, FL 34747, United States.
Department of Otolaryngology - Head and Neck Surgery, AdventHealth Orlando, 410 Celebration Place, Celebration, FL 34747, United States; Department of Otolaryngology - Head and Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, FL, United States; Department of Surgery, University of Auckland School of Medicine and Allied Health Sciences, Auckland, New Zealand.
Oral Oncol. 2024 Jul;154:106855. doi: 10.1016/j.oraloncology.2024.106855. Epub 2024 May 23.
Human papillomavirus (HPV) has emerged as a potential etiological factor in sinonasal squamous cell carcinoma (SNSCC), but a clear understanding of HPV prevalence and its temporal patterns in SNSCC remains elusive. This study aimed to investigate temporal trends in HPV testing and positivity rates, and explore demographic and geographic factors associated with these trends.
A retrospective cohort study included patients diagnosed with invasive SNSCC between 2011 and 2017 from the US National Cancer Database (NCDB). Prevalence ratios (PR) of HPV positivity and testing rates were estimated with the corresponding 95% confidence interval (95% CI).
The overall HPV testing rate was 45.4 % (N = 1762/3880), and the prevalence of HPV testing significantly decreased during the study period (adjusted PR: 0.97, 95 % CI: 0.95 - 0.99, p < 0.001). Overall HPV positivity frequency was 37.3 % (N = 650/1741), and the overall prevalence of HPV positive tumors significantly increased during the study period (adjusted PR: 1.04, 95 % CI: 1.02 - 1.05, p < 0.001). The increase in HPV positivity rate was observed solely in the white population (unadjusted PR: 1.10, 95 % CI: 1.06 - 1.14; p < 0.001). A significant geographical variation was observed for both HPV testing (range: 28.6 % - 61.7 %) and positivity (range: 28.3 % - 44.7 %).
This study provides novel insights into the temporal trends and demographic factors associated with HPV testing and positivity in SNSCC. Despite increasing HPV positivity rates, disparities in testing rates persist, highlighting the need for standardized testing protocols and targeted interventions.
人乳头瘤病毒（HPV）已成为鼻窦鳞状细胞癌（SNSCC）的潜在病因，但对 SNSCC 中 HPV 的流行程度及其时间模式仍不清楚。本研究旨在调查 HPV 检测和阳性率的时间趋势，并探讨与这些趋势相关的人口统计学和地理因素。
一项回顾性队列研究纳入了 2011 年至 2017 年期间美国国家癌症数据库（NCDB）中诊断为侵袭性 SNSCC 的患者。使用相应的 95%置信区间（95%CI）估计 HPV 阳性率和检测率的患病率比（PR）。
总体 HPV 检测率为 45.4%（N=1762/3880），研究期间 HPV 检测的流行率显著下降（调整后的 PR：0.97，95%CI：0.95-0.99，p<0.001）。总体 HPV 阳性率为 37.3%（N=650/1741），研究期间 HPV 阳性肿瘤的总体流行率显著增加（调整后的 PR：1.04，95%CI：1.02-1.05，p<0.001）。HPV 阳性率的增加仅在白人人群中观察到（未调整的 PR：1.10，95%CI：1.06-1.14；p<0.001）。HPV 检测（范围：28.6%-61.7%）和阳性率（范围：28.3%-44.7%）均存在显著的地理差异。
本研究提供了关于 SNSCC 中 HPV 检测和阳性率的时间趋势和人口统计学因素的新见解。尽管 HPV 阳性率不断上升，但检测率仍存在差异，这突显了标准化检测方案和针对性干预的必要性。
