ArticlePloS one2021
Understanding the impact of high-risk human papillomavirus on oropharyngeal squamous cell carcinomas in Taiwan: A retrospective cohort study.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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13 citing papers in PubMed, 23 citations in OpenAlex.
- Prognostic heterogeneity of HPV-associated oropharyngeal cancer in a Taiwanese population.BMC cancer · 2026Article
- Oncogenic viruses and their role in oral cavity and oropharyngeal squamous cell carcinoma: a systematic review.Frontiers in oncology · 2026Review
- HPV associated oropharyngeal cancer in eastern China over the last 7 years: is the incidence in chinese truly exceptionally low?BMC public health · 2025Article
- Detection, quantitation, and genotyping of human papillomavirus circulating tumor DNA by droplet digital PCR.Journal of clinical microbiology · 2025Article
- Overall and disease-free survival in patients with HPV-positive and HPV-negative oropharyngeal cancer.Einstein (Sao Paulo, Brazil) · 2025Article
- Association Between Human Papillomavirus and Thymic Cancer: A Population-Based Cohort Study.Cancer management and research · 2025Article
- Incremental net benefit of extending human papillomavirus vaccine to boys in oropharyngeal cancer burden: Meta-analysis of cost-effectiveness studies.Journal of dental sciences · 2024Article
- HPV-Related Oropharyngeal Cancer in Southern Thailand: Proportion Trend and Survival Outcome.Asian Pacific journal of cancer prevention : APJCP · 2024Article
- Application of Carotid Duplex Ultrasonography in the Surveillance of Carotid Artery Stenosis after Neck Irradiation.Reviews in cardiovascular medicine · 2022Review
- A predictive model for advanced oropharyngeal cancer patients treated with chemoradiation.BMC cancer · 2022Article
- Update on the Epidemiological Features and Clinical Implications of Human Papillomavirus Infection (HPV) and Human Immunodeficiency Virus (HIV) Coinfection.Microorganisms · 2022Review
- Rising incidence of HPV positive oropharyngeal cancer in Taiwan between 1999 and 2014 where betel nut chewing is common.BMC cancer · 2022Article
- Review
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Authors and funding
15 authors at 3 institutions in 2 countries.
Funding
Abstract
BACKGROUND AND
objectivesHuman papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally. In Taiwan, HPV-positive OPSCC is obscured by tobacco, alcohol, and betel quid use. We investigated the role of high-risk HPV (hrHPV) in a large retrospective Taiwan OPSCC cohort. METHODS AND
resultsThe cohort of 541 OPSCCs treated at Chang Gung Memorial Hospital from 1998-2016 consisted of 507 men (94%) and 34 women (6%). Most used tobacco (81%), alcohol (51%), and betel quid (65%). Formalin-fixed, paraffin-embedded tissue was used for p16 staining (a surrogate marker for HPV) and testing for HPV DNA presence and type by Multiplex HPV PCR-MassArray. HPV DNA and/or p16 staining (HPV-positive) was found in 28.4% (150/528) tumors. p16 and HPV DNA were strongly correlated (F < 0.0001). HPV16 was present in 82.8%, and HPV58 in 7.5% of HPV-positive tumors. HPV was associated with higher age (55.5 vs. 52.7 years, p = 0.004), lower T-stage (p = 0.008) better overall survival (OS) (hazard ratio [HR] 0.58 [95% CI 0.42-0.81], p = 0.001), and disease-free survival (DFS) (HR 0.54 [95% CI 0.40-0.73], p < 0.0001). Alcohol was strongly associated with recurrence and death (OS: HR 2.06 [95% CI 1.54-2.74], p < 0.0001; DFS: HR 1.72 [95% CI 1.33-2.24], p < 0.0001). OS and DFS in HPV-positive cases decreased for alcohol users (p < 0.0001). Obscured by the strong alcohol effect, predictive associations were not found for tobacco or betel quid.
conclusionsAs with HPV-positive OPSCC globally, HPV is an increasingly important etiological factor in Taiwanese OPSCC. HPV-positive OPSCC has considerable survival benefit, but this is reduced by alcohol, tobacco, and betel quid use. hrHPV is a cancer risk factor in males and females. Vaccinating both sexes with a multivalent vaccine including HPV58, combined with alcohol and tobacco cessation policies will be effective cancer-prevention public health strategies in Taiwan.
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