Human papillomavirus genotypes and risk of head and neck cancers: Results from the HeNCe Life case-control study

Objective Human papillomaviruses (HPV) are changing dramatically the epidemiologic landscape of head and neck cancers (HNCs). Their role in the aetiology of these cancers varies widely among HNCs subsites, sex and geographical regions worldwide. We describe HPV prevalence and its association with HNCs risk overall and by anatomical subsite in a sample of Canadians. Materials and methods The HeNCe Life study recruited 460 incident HNCs cases and 458 controls frequency-matched by age and sex from four Montreal hospitals in 2005–2013. We tested oral rinse and oral brush specimens for mucosal HPV genotypes. HPV positivity was categorized hierarchically as either negative, exclusively non-α-9 species types, α-9 types other than HPV16, and HPV16. We estimated odds ratios (OR) and 95% confidence intervals (CI) for the associations between HPV and HNCs using unconditional logistic regression, controlling for confounders. Results The prevalence of HPV infection among controls and cases was 14.5% and 41.2% in oral rinse and 3.1% and 24.4% in oral brush samples, respectively. HPV16 was the predominant genotype with an oral rinse and oral brush prevalence of 26.3% and 16.2% among cases and 2.4% and 0.2% among controls, respectively. HPV infection was associated with an increased risk of HNCs overall (OR = 4.18; 95% CI, 2.94–5.95) and oropharyngeal cancer only (OR = 10.3; 95% CI, 6.8–15.7). HNCs and oropharyngeal cancer were strongly associated with HPV16 (OR = 18.1; 95% CI, 9.1–35.8, and OR = 47.2; 95% CI, 23.1–96.6, respectively). Conclusion HPV infection, particularly HPV16, was associated with an increased HNCs risk, most strongly for oropharyngeal cancers.