B119: Oropharyngeal cancers attributable to HPV in the United Kingdom: a cross-sectional observational multi-centre study

Andrew Schache1,2,Ned Powell3,Max Robinson6,Kate Cushieri4,Mererid Evans5,Terry Jones1,2

1University of Liverpool, Liverpool, UK,2Aintree University Hospital, Liverpool, UK,3Cardiff University, Cardiff, UK,4Scottish Human Papillomavirus Reference Laboratory, Edinburgh, UK,5Velindre NHS Trust, Cardiff, UK,6Newcastle University, Newcastle, UK

Presenting date: Tuesday 3 November
Presenting time: 12.20-13.10

Background

Over the last two decades, a rapid rise in the incidence of Oropharyngeal Squamous Cell Carcinoma (OPSCC) has been evident within many developed nations. In the United Kingdom (UK), the incidence of OPSCC has more than doubled between 2002-2011, while rates of other head and neck cancers remained largely stable.

This study aimed to provide the first accurate determination of the proportion of OPSCC caused by HPV within the UK (2002-2011).

Method

Archival OPSCC tissue blocks were obtained from 11 geographically dispersed centres, across the four constituent countries of the UK. For each year, 175 blocks were requested.

HPV testing was performed using p16 immunohistochemistry (CINtec), in-situ-hybridisation (ISH;Inform HPV III) and PCR (Optiplex HPV).

The data were analysed in relation to cancer registry data detailing incidence for the same period in the United Kingdom.

Results

Valid results were obtained for 1479 cases; 50.8% of samples tested positive for HPV. The mean age of patients was 59.3 years; younger patients were more likely to test positive for HPV.

The proportion of HPV-positive samples did not increase from 2002-2011. This finding was apparent irrespective of the HPV diagnostic test applied.

Conclusion

This is the first UK-wide study to investigate the proportion of OPSCC caused by HPV.

We report trends in the UK population that are contrary to those reported for other European and North American populations. Unbiased case-selection and methodologically rigorous HPV testing, employing the use of multiple, validated assays conducted at geographically distinct sites, supports the validity of this finding.

The incidence of HPV-positive OPSCC approximately doubled from 2002-2011; however this was matched by a similar increase in incidence of HPV-negative OPSCC. The reasons for this increase in HPV-negative OPSCC are unclear, however the impact of changing trends in paediatric tonsillectomies in recent decades may hold relevance to both groups.