Prevalence of HPV Infection in Racial-Ethnic Subgroups of Head and Neck Cancer Patients

Camille Ragin; Jeffrey C Liu; Gieira Jones; Olubunmi Shoyele; Bukola Sowunmi; Rachel Kennett; Harry J M Groen; Denise Gibbs; Elizabeth Blackman; Michael Esan; Margaret S Brandwein; Karthik Devarajan; Francesco Bussu; Rebecca Chernock; Chih-Yen Chien; Marc A Cohen; El-Mofty Samir; Suzuki Mikio; Gypsyamber D'Souza; Pauline Funchain; Charis Eng; Susanne M Gollin; Angela Hong; Yuh-S Jung; Maximilian Krüger; James Lewis Jr; Patrizia Morbini; Santo Landolfo; Massimo Rittà; Jos Straetmans; Krisztina Szarka; Ruth Tachezy; Francis P Worden; Deborah Nelson; Samuel Gathere; Emanuela Taioli

doi:10.1093/carcin/bgw203

Prevalence of HPV Infection in Racial-Ethnic Subgroups of Head and Neck Cancer Patients

Carcinogenesis. 2017 Feb;38(2):218-229. doi: 10.1093/carcin/bgw203. Epub 2016 Dec 26.

Authors

Camille Ragin^{1

2}, Jeffrey C Liu³, Gieira Jones², Olubunmi Shoyele⁴, Bukola Sowunmi⁵, Rachel Kennett⁵, Harry J M Groen², Denise Gibbs⁵, Elizabeth Blackman^{5

2}, Michael Esan⁵, Margaret S Brandwein⁶, Karthik Devarajan⁷, Francesco Bussu⁸, Rebecca Chernock⁹, Chih-Yen Chien¹⁰, Marc A Cohen¹¹, El-Mofty Samir⁹, Suzuki Mikio¹², Gypsyamber D'Souza¹³, Pauline Funchain¹⁴, Charis Eng¹⁴, Susanne M Gollin¹⁵, Angela Hong¹⁶, Yuh-S Jung¹⁷, Maximilian Krüger¹⁸, James Lewis Jr¹⁹, Patrizia Morbini²⁰, Santo Landolfo²¹, Massimo Rittà²¹, Jos Straetmans²², Krisztina Szarka²³, Ruth Tachezy²⁴, Francis P Worden²⁵, Deborah Nelson², Samuel Gathere²⁶, Emanuela Taioli²⁷

Affiliations

¹ Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA Camille.ragin@fccc.edu.
² Department of Epidemiology & Biostatistics, Temple University, College of Public Health, Philadelphia, PA, USA.
³ Department of Otolaryngology, Temple University; and Fox Chase Cancer Center, Philadelphia, PA, USA.
⁴ Department of Pathology and Laboratory Medicine, Western Connecticut Health Network, Danbury Hospital, Danbury, CT, USA.
⁵ Cancer Prevention and Control Program, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA.
⁶ Department of Pathology and Anatomical Sciences, SUNY at the University at Buffalo, Buffalo, NY, USA.
⁷ Department of Biostatistics, Fox Chase Cancer Center - Temple Health, Philadelphia, PA, USA.
⁸ Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy.
⁹ Department of Pathology and Immunology, Washington University School of Medicine, St Louis, MO, USA.
¹⁰ Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
¹¹ Department of Surgery, Head and Neck Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
¹² Department of Otorhinolaryngology, Head and Neck Surgery, Graduate School of Medicine, University of the Ryukyus, Okinawa, Japan.
¹³ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
¹⁴ Genomic Medicine Institute, Cleveland Clinic Lerner Research Institute, Cleveland, OH, USA.
¹⁵ Department of Human Genetics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA USA.
¹⁶ Central Clinical School, The University of Sydney, Sydney, NSW, Australia.
¹⁷ Department of Otolaryngology, Research Institute and Hospital, National Cancer Center, Gyeonggi-do, Korea.
¹⁸ Department of Oral and Maxillofacial Surgery - Plastic Surgery, University Medical Center of the Johannes Gutenberg-University, Mainz, Germany.
¹⁹ Department of Pathology, Microbiology, and Immunology, Vanderbilt University, Nashville, TN, 37232, USA.
²⁰ Department of Molecular Medicine, Unit of Pathology, University of Pavia, and à IRCCS Policlinico S. Matteo Foundation, Pavia, Italy.
²¹ Department of Sciences of Public Health and Pediatrics, University of Turin, Turin, Italy.
²² Department of Otorhinolaryngology-Head and Neck Surgery, GROW Institute, Maastricht University Medical Centre, Maastricht, The Netherlands.
²³ Department of Medical Microbiology, Faculty of Medicine, University of Debrecen, Hungary.
²⁴ Department of Immunology, Institute of Hematology and Blood Transfusion National Reference Laboratory for Papillomaviruses, Prague, Czech Republic.
²⁵ Department of Internal Medicine, Division of Hematology-Oncology, University of Michigan, Ann Arbor, MI, USA.
²⁶ Non Communicable Diseases Research Programme, Kenya Medical Research Institute, Nairobi, Kenya.
²⁷ Departments of Population Health Science and Policy, of Thoracic Surgery, and Institute For Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.

Abstract

The landscape of HPV infection in racial/ethnic subgroups of head and neck cancer (HNC) patients has not been evaluated carefully. In this study, a meta-analysis examined the prevalence of HPV in HNC patients of African ancestry. Additionally, a pooled analysis of subject-level data was also performed to investigate HPV prevalence and patterns of p16 (CDNK2A) expression amongst different racial groups. Eighteen publications (N = 798 Black HNC patients) were examined in the meta-analysis, and the pooled analysis included 29 datasets comprised of 3,129 HNC patients of diverse racial/ethnic background. The meta-analysis revealed that the prevalence of HPV16 was higher among Blacks with oropharyngeal cancer than Blacks with non-oropharyngeal cancer. However, there was great heterogeneity observed among studies (Q test P<0.0001). In the pooled analysis, after adjusting for each study, year of diagnosis, age, gender and smoking status, the prevalence of HPV16/18 in oropharyngeal cancer patients was highest in Whites (61.1%), followed by 58.0% in Blacks and 25.2% in Asians (P<0.0001). There was no statistically significant difference in HPV16/18 prevalence in non-oropharyngeal cancer by race (P=0.682). With regard to the pattern of HPV16/18 status and p16 expression, White patients had the highest proportion of HPV16/18+/p16+ oropharyngeal cancer (52.3%), while Asians and Blacks had significantly lower proportions (23.0% and 22.6%, respectively) [P <0.0001]. Our findings suggest that the pattern of HPV16/18 status and p16 expression in oropharyngeal cancer appears to differ by race and this may contribute to survival disparities.

Grants and funding

P30 CA006927/CA/NCI NIH HHS/United States