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Human papillomavirus infection and non-oropharyngeal head and neck cancers: an umbrella review of meta-analysis

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Abstract

Objective

The causative and prognostic roles of human papillomavirus (HPV) in non-oropharyngeal squamous cell carcinoma of the head and neck are uncertain. This umbrella review assessed the strength and quality of evidence and graded the evidence derived from published meta-analyses on this subject.

Data sources: MEDLINE, Embase, and the Cochrane Library were searched. Meta-analyses of observational studies and randomized trials were included.

Review methods: Evidence of association was graded according to the established criteria: strong, highly suggestive, suggestive, weak, or not significant.

Results

15 meta-analyses were evaluated. The association with HPV was highly suggestive of oral (OR = 2.40, [1.87–3.07], P < 0.00001) and nasopharyngeal cancers (OR = 17.82 [11.20–28.35], P < 0.00001). Improved survival emerged only in hypopharyngeal carcinoma and was confirmed in studies in which only p16 + cancers were considered.

Conclusion

HPV infection may increase the risk of oral cavity and nasopharyngeal cancer. However, the prognosis was not influenced, except in hypopharyngeal carcinoma.

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Author notes

    Authors and Affiliations

    1. Oncology Unit, Medical Sciences Department, ASST Bergamo Ovest, Piazzale Ospedale 1, 24047, Treviglio, BG, Italy

      Fausto Petrelli & Andrea Luciani

    2. ENT Unit, Head and Neck Department, Mestre Hospital, ULSS 3, Venice, VE, Italy

      Elisa Dal Cin

    3. Oncology Unit, Casa Di Cura Igea, Milan, Italy

      Antonio Ghidini

    4. Otorhinolaringology Unit, Department of Neuroscience, ASST Bergamo Ovest, Treviglio, BG, Italy

      Daniela Carioli, Vincenzo Falasca, Massimiliano Nardone & Vincenzo Capriotti

    5. Radiotherapy Unit, ASST Bergamo Ovest, Treviglio, BG, Italy

      Agostina De Stefani

    6. Ufficio Relazioni Col Pubblico, ASST Bergamo Ovest, Treviglio, BG, Italy

      Giovanna Moleri

    7. IRCCS Centro Di Riferimento Oncologico Della Basilicata (CROB), Oncological Day Hospital, Via Padre Pio 1, 85028, Rionero in Vulture, PZ, Italy

      Raffaele Ardito

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    1. Fausto Petrelli
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    Petrelli, F., Cin, E.D., Ghidini, A. et al. Human papillomavirus infection and non-oropharyngeal head and neck cancers: an umbrella review of meta-analysis. Eur Arch Otorhinolaryngol 280, 3921–3930 (2023). https://doi.org/10.1007/s00405-023-08027-4

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