Is socio-economic status relevant in HPV oropharyngeal cancer?


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Yinan Zhu1,Athena Togo2,Rohit Gohil2,Richard Oparka2,Jaiganesh Manickavasagam2
1University of Dundee,2NHS Tayside

Abstract

Background

Ten years ago, oropharyngeal squamous cell carcinoma (OPSCC) is documented to be the fastest rising cancer in Scotland. Smoking, alcohol and HPV infection are known major risk factors. Other risk factors discussed in the literature includes age, gender and socioeconomic factors.

Method

This paper serves to provide an insight into Tayside OPSCC epidemiological trends in the form of a cross sectional study. Complete data is collected from the pathology department of Ninewells Hospital in Dundee from January 2005 to January 2012. This is supplemented with details from patient case notes. Information obtained for each eligible OPSCC case includes the age at diagnosis, gender, biopsy HPV status, smoking and alcohol status, and postcode sector of residence. The Carstairs Index was chosen as the measurement of socioeconomic status for this study.

Results

A total of 84 patients were documented. The trend of OPSCC incidence observed in the Tayside population resembles a cyclical pattern, and shows no overall rise/fall over the data period, regardless of HPV status. 70.2% of all OPSCC cases were male. 63.1% of all OPSCC cases were HPV-positive. Average age at diagnosis is 62.0 in HPV-negative cases compared to 58.3 in HPV-positive cases. The prevalence of current or ex-smokers amongst the HPV-negative group is 95.8%, compared with 57.5% for the HPV-positive group. Incidence was variable amongst the postcode districts, with no observable trend.

Conclusion

Local trends observed in Tayside yielded similarities to national trends in terms of gender distribution favouring males, lower average age at diagnosis for HPV-positive OPSCC and a strong correlation between positive current/previous smoking status with HPV-negative OPSCC. However, major disparities include the lack of an overall rising trend in the incidence of OPSCC, particularly that of HPV-positive cases. This study also found no relationship between socioeconomic status and OPSCC incidence, for both HPV-positive and HPV-negative cases.