Racovitan Voica, Goodman Elizabeth, Cheung Winson Y, Nichols Anthony C, Caulley Lisa, Wurzba Sabrina
Global Marketing HPV Strategy, Merck & Co. Inc ., North Wales, PA, USA.
Vaccine Outcomes Research, Value and Implementation, Merck and Co., Inc ., North Wales, PA, USA.
Hum Vaccin Immunother. 2025 Dec;21(1):2486768. doi: 10.1080/21645515.2025.2486768. Epub 2025 Apr 23.
Oral human papillomavirus (HPV) infection is a risk for oropharyngeal cancer (OPC), now the leading HPV-related cancer in males in Canada. P16 positivity is a marker of HPV positivity. Since 2015, all major Canadian cancer centers perform routine p16 tumor marker testing of OPCs to define their HPV status but recent data on the HPV-attributable fraction for OPC in Canada do not exist. A retrospective chart review was conducted of all squamous cell OPC cases in patients 18 years and older diagnosed from 2016 to 2020 in 4 major Canadian hospital-based regional oncology centers to determine the HPV attributable fraction for OPC in Canada using p16 as a surrogate marker for HPV. 1154 OPC cases were identified. Most patients (85.4%) were male; about one-third 26 (31.4%) had never smoked. Most OPC (80.6%) were P16 positive. p16 positivity was 27 associated with younger age (mean age p16+ 61.6 vs. p16- 66.5 years, < 0.0001), male sex 28 (p16+ males 84.0% vs p16+ females 60.9%, p < 0.0001), lower tumor stage (Stage 1 p16+ 29 88.1% vs Stage 4 p16+ 69.4%, < 0.001), and non-smoking (never smoked 92.3% vs past 30 smoker 82.8% vs current smoker 65.0%, < 0.001). Logistic regression confirmed these 31 associations. This study, the largest cohort of Canadian patients with OPC yet reported, demonstrates the high attributable fraction for HPV-related OPC. HPV-related OPC was more likely in men, younger individuals, and never smokers. These findings highlight the burden of HPV-related OPC in Canada and support gender-neutral HPV vaccination as an important public health strategy to prevent head and neck cancer.
口腔人乳头瘤病毒（HPV）感染是口咽癌（OPC）的一个风险因素，口咽癌是目前加拿大男性中主要的HPV相关癌症。P16阳性是HPV阳性的一个标志物。自2015年以来，加拿大所有主要癌症中心都对口咽癌进行常规的p16肿瘤标志物检测，以确定其HPV状态，但目前尚无加拿大口咽癌HPV归因比例的最新数据。对2016年至2020年在加拿大4家主要的以医院为基础的区域肿瘤中心确诊的18岁及以上患者的所有鳞状细胞口咽癌病例进行了回顾性图表审查，以使用p16作为HPV的替代标志物来确定加拿大口咽癌的HPV归因比例。共识别出了1154例口咽癌病例。大多数患者（85.4%）为男性；约三分之一（31.4%）从未吸烟。大多数口咽癌（80.6%）为P16阳性。p16阳性与较年轻的年龄相关（p16阳性患者的平均年龄为61.6岁，p16阴性患者为66.5岁，<0.0001）、男性（p16阳性男性为84.0%，p16阳性女性为60.9%；p<0.0001）、较低的肿瘤分期（1期p16阳性为88.1%，4期p16阳性为69.4%，<0.001）以及不吸烟（从未吸烟者为92.3%，过去吸烟者为82.8%，当前吸烟者为65.0%，<0.001）。逻辑回归证实了这些关联。这项研究是迄今为止报告的加拿大口咽癌患者最大队列研究，证明了HPV相关口咽癌归因比例很高。HPV相关口咽癌在男性、年轻人和从不吸烟者中更常见。这些发现凸显了加拿大HPV相关口咽癌的负担，并支持不分性别的HPV疫苗接种作为预防头颈癌的一项重要公共卫生策略。
