Epidemiology of otorhinolaryngological squamous cell papillomas in a Spanish subpopulation during a 20 year period.

We present a study of the incidence of squamous cell papillomas on the otorhinolaryngological field, in a population of approximately 500,000 inhabitants between 1973 and 1992. We have reviewed 234 papillomas. The overall incidence of ENT papillomas was 2.4737 x 10(5) inhabitants per year. The most frequent location was the pharynx, followed by oral cavity, larynx and sinonasal tract. In the ear these lesions were very rare. No significant increase in incidence rates were found over the four year periods, except for pharyngeal papillomas. The median age at onset of ENT papillomas was 47.11 years (range = 4 to 83 years). Only 7,3% of papillomas were of juvenile type. The male to female ratio was 2,1. Male preponderance occurred in pharyngeal and laryngeal papillomas. Only lesions of the ear were most frequent in the female population. 54,9% of patients were smokers. The highest incidence of smoking habit was found in laryngeal papillomas. Only two patients in our series had HIV infection, and in both cases the papillomas were located in the oral cavity. This study shows that the incidence of ENT papillomas has remained constant and that adult preponderance is more marked in our population than in others reported previously. The pathogenesis of the ENT squamous papillomas in our population is related with an acquired HPV infection without clear relation to genital disease.