Humans ; Incidence ; Oropharyngeal Neoplasms/epidemiology* ; Papillomaviridae ; Papillomavirus Infections/epidemiology* ; Singapore/epidemiology*

UNLABELLEDOBJECTIVE To examine survival differences in prognosis and survival between patients with HPV-positive and those with HPV-negative oropharyngeal squamous cell carcinoma (OPSCC).

METHODSPubmed, Embase, Web of science and Medline databases were searched from their inception till June 2014. A random-effect meta-analysis was used to pool study estimates evaluating overall (all-cause mortality), disease-specific (death from OPSCC), disease-free (recurrence free), progression-free survival outcomes and local regional control rate in HPV-positive vs HPV-negative OPSCC. After study selection, two reviewers assessed and extracted data independently. Meta-analysis was performed using the STATA 11.0 software.

RESULTSThirty-seven studies were included. HPV-positive OPSCC patients had a better overall survival compared to HPV-negative patients (HR 0.39, 95% CI 0.32-0.46). HPV-positive OPSCC patients had a significantly lower disease specific mortality (HR 0.31, 95% CI 0.22-0.39) and were less likely to experience progression or recurrence of their cancers than HPV-negative patients (HR 0.34, 95% CI 0.25-0.42). Both disease-free survival and progression-free survival were significantly improved in patients with HPV-positive OPSCC ( HR 0.38, 95% CI 0.29-0.47 and HR 0.46, 95% CI 0.29-0.63, respectively).

CONCLUSIONSHPV infection is an important prognostic factor of OPSCC. Stratified therapies can be applied in OPSCC based on HPV status of tumours.

Carcinoma, Squamous Cell ; diagnosis ; epidemiology ; Disease-Free Survival ; Humans ; Oropharyngeal Neoplasms ; diagnosis ; epidemiology ; Papillomaviridae ; Papillomavirus Infections ; epidemiology ; Prognosis

High-risk human papillomavirus (HPV)-related cancers consist of cervical cancer, anal cancer, penile cancer, vulvar cancer, vaginal cancer, and head and neck cancer (HNC). Of these, the disease burden of HNC is second only to cervical cancer. HNC mostly originates from malignant lesions of squamous epithelial cells and mainly includes oral cavity cancer, pharyngeal cancer (including nasopharyngeal cancer, oropharyngeal cancer, and hypopharyngeal cancer), and laryngeal cancer. Tobacco use, alcohol abuse, and HPV infection are three primary risk factors. Recently, there is an upward trend of HNC incidence globally, especially in high-income countries. In China, the disease burden and trends of HPV-related HNC are still not clear. A few small sample size and single-center studies suggest a high HPV prevalence and increasing trend in HNC. Methodological differences in HPV testing and regional variabilities still exist among these studies. Among the anatomic sites, oropharyngeal cancer has been shown to be caused by HPV infection, but the association of HPV with other sites is still under debate. In addition, there is a paucity of relevant studies. Here, this review narrates the association between HPV infection and HNC, compares the differences between global and Chinese studies, and then explores the importance of HPV infection in various anatomical sites. The main objective is to highlight the research on HPV-related HNC and promote relevant prevention and treatment programs.
Female ; Humans ; Human Papillomavirus Viruses ; Papillomavirus Infections/prevention & control* ; Uterine Cervical Neoplasms/complications* ; Nasopharyngeal Neoplasms/complications* ; Head and Neck Neoplasms/epidemiology* ; Oropharyngeal Neoplasms/epidemiology* ; Papillomaviridae

Objective: We aim to evaluate the morbidity and mortality of cancer attributable to human papillomavirus (HPV) infection in China in 2016. Methods: Based on the cancer incidence and mortality rates, national population data, and population attributable fraction (PAF) in China, we calculated the number of incidence and death cases attributed to HPV infection in different areas, age groups, and gender in China in 2016. The standardized incidence and mortality rates for cancer attributed to HPV infection were calculated by using Segi's population. Results: In 2016, a total of 124 772 new cancer cases (6.32 per 100 000) were attributed to HPV infection in China, including 117 118 cases in women and 7 654 cases in men. Of these cancers, cervical cancer was the most common one, followed by anal cancer, oropharyngeal cancer, penile cancer, vaginal cancer, laryngeal cancer, oral cancer, and vulvar cancer. A total of 41 282 (2.03 per 100 000) deaths were attributed to HPV infection, of which 37 417 occurred in women and 3 865 in men. Most deaths were caused by cervical cancer, followed by anal cancer, oropharyngeal cancer, penile cancer, laryngeal cancer, vaginal cancer, oral cancer, and vulvar cancer. The incidence and mortality rates of cervical cancer increased rapidly with age, peaked in age group 50-54 years, then decreased obviously. The morbidity and mortality rates of non-cervical cancer increased with age. The cancer case and death numbers in rural areas (57 089 cases and 19 485 deaths) were lower than those in urban areas (67 683 cases and 21 797 deaths). However, the age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of cervical cancer were higher in rural areas than in urban areas. There were no significant differences in ASIR and ASMR of non-cervical cancers between urban areas and rural areas. Conclusions: The incidence of cancers attributed to HPV infection in China was lower than the global average, but the number of incidences accounted largely, furthermore there is an increasing trend of morbidity and mortality. The preventions and controls of cervical cancer and male anal cancer are essential to contain the increases in cancer cases and deaths attributed to HPV infection.
China/epidemiology* ; Female ; Humans ; Incidence ; Laryngeal Neoplasms ; Male ; Middle Aged ; Mouth Neoplasms ; Oropharyngeal Neoplasms/epidemiology* ; Papillomavirus Infections/epidemiology* ; Penile Neoplasms/epidemiology* ; Registries ; Uterine Cervical Neoplasms/epidemiology* ; Vaginal Neoplasms ; Vulvar Neoplasms

OBJECTIVETo investigate the clinicopathological features, treatment outcomes and prognosis of patients with oropharyngeal squamous cell carcinoma (OSCC).

METHODSRetrospective review of 318 consecutive cases with OSCC treated from January 1999 to December 2011. Survival rates and prognostic factors were calculated using the Kaplan-Meier method and multivariate Cox model survival analysis respectively. There were 281 males and 37 females, with a median age of 56 years. Of the 318 cases, 163 carcinomas were from tonsil, 108 from tongue base and 47 from soft palate-uvula. The presenting symptoms were pharyngalgia (128 cases, 40.3%), neck masses (71 cases, 22.3%), foreign body sensation in the pharynx (63 cases, 19.8%) and dental ulcer (44 cases, 13.8%). The median time from onset of the first symptoms until diagnosis of OSCC was 3 months. Of the 318 OSCC, 75 were with high grade, 110 with intermediate grade and 133 with low grade, including 10 patients at stageI, 39 at stage II, 68 at stage III and 201 at stage IV.

RESULTSThe rates of lymph node metastasis, distant metastasis and second primary carcinoma were 72.3%, 13.2% and 7.9%, respectively. Of 318 patients, 117 received radiotherapy alone, 66 underwent surgery plus postoperative radiotherapy, 59 underwent preoperative radiotherapy plus surgery, 33 received concomitant chemotherapy and radiotherapy, 20 received concomitant molecular targeted therapy and radiotherapy, 16 underwent surgery alone and 7 received induction chemotherapy plus radiotherapy. The 3-, 5-year overall survival (OS) rates were 58.4%, 50.7%, respectively, and the median overall survival time was 60.1 months. Ages (P = 0.034), gender(P = 0.024), smoking and alcohol consumptions(P = 0.008), doses of radiotherapy(P = 0.046) and clinic stages(P = 0.001) were independent factors for OS.

CONCLUSIONSOSCC is poor in prognosis, with a high incidence of cervical lymph node metastasis. Radiotherapy and salvage surgery are the main treatments for OSCC.

Carcinoma, Squamous Cell ; diagnosis ; epidemiology ; Female ; Humans ; Lymph Nodes ; Lymphatic Metastasis ; diagnosis ; Male ; Oropharyngeal Neoplasms ; diagnosis ; epidemiology ; Prognosis ; Retrospective Studies ; Survival Rate ; Treatment Outcome

BACKGROUND: The numbers of patients on dialysis and their life expectancies are increasing. Reduced renal function is associated with an increased risk of cancer, but the cancer incidence and sites in dialysis patients compared with those of the general population require further investigation. We investigated the incidences of various cancers in dialysis patients in Korea and used national health insurance data to identify cancers that should be screened in dialysis clinics. METHODS: We accessed the Korean National Health Insurance Database and excerpted data using the International Classification of Disease codes for dialysis and malignancies. We included all patients who commenced dialysis between 2004 and 2013 and selected the same number of controls via propensity score matching. RESULTS: A total of 48,315 dialysis patients and controls were evaluated; of these, 2,504 (5.2%) dialysis patients and 2,201 (4.6%) controls developed cancer. The overall cancer risk was 1.54-fold higher in dialysis patients than in controls (adjusted hazard ratio, 1.71; 95% confidence interval, 1.61–1.81). The cancer incidence rate (incidence rate ratio [IRR], 3.27) was especially high in younger dialysis patients (aged 0–29 years). The most common malignancy of end-stage renal disease patients and controls was colorectal cancer. The major primary cancer sites in dialysis patients were liver and stomach, followed by the lung, kidney, and urinary tract. Kidney cancer exhibited the highest IRR (6.75), followed by upper urinary tract (4.00) and skin cancer (3.38). The rates of prostate cancer (0.54) and oropharyngeal cancer (0.72) were lower than those in the general population. CONCLUSION: Dialysis patients exhibited a higher incidence of malignancy than controls. Dialysis patients should be screened in terms of colorectal, liver, lung, kidney and urinary tract malignancies in dialysis clinics.
Colorectal Neoplasms ; Dialysis ; Epidemiology ; Humans ; Incidence ; International Classification of Diseases ; Kidney ; Kidney Failure, Chronic ; Kidney Neoplasms ; Korea ; Life Expectancy ; Liver ; Lung ; National Health Programs ; Oropharyngeal Neoplasms ; Propensity Score ; Prostatic Neoplasms ; Renal Dialysis ; Skin Neoplasms ; Stomach ; Urinary Tract