ArticleBMC public health2025
HPV associated oropharyngeal cancer in eastern China over the last 7 years: is the incidence in chinese truly exceptionally low?
Article in BMC public health, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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Abstract
backgroundThe prevalence of human papillomavirus (HPV) in oropharyngeal squamous cell carcinoma (OPSCC) in China was reported to be remarkably low. Clinicians often prioritize HPV-unrelated OPSCC cases without fully recognizing the clinical and public health significance of HPV-related ones. We conducted a 7-year retrospective study on OPSCCs in China’s highly developed eastern region, aiming to elucidate the clinical and demographic characteristics.
methodsThe presence of HPV infection was determined using p16-immunohistochemistry in pretreatment samples obtained from all patients diagnosed with OPSCC at Eye & ENT Hospital of Fudan University between 2017 and 2023. A Total of 388 OPSCCs comprised 313 males and 75 females were analyzed.
resultsp16-positivity rate was 62.6%. The proportion of p16-positive patients increased steadily from 45.5% (2017) to 69.5% (2023). Females exhibited significantly higher p16 positivity rates compared to negativity (84% vs. 16%, p < 0.001), surpassing the proportion in males (84% vs. 57.5%, p < 0.001). Patients with p16-positive were younger, and males had a higher mean age (p < 0.05). The incidence rates peaked at an earlier age for p16-positive OPSCC, while there was a wider range of ages among p16-negative patients. The proportion of smokers (51% vs. 77.2%) and drinkers (41.2% vs. 68.3%) was significantly lower in p16-positive OPSCCs (p < 0.001), merely 3.2% of female patients engaged in smoking or drinking behaviors. Although the number of p16-positive cases was higher in urban areas, there was a notable rise in p16-positivity rate observed in rural areas between 2019 (16.7%) and 2023 (57.1%). p16-positive tumors were more commonly found in tonsil than negative ones (80.7% vs. 56.6%, p < 0.001). The proportion of p16-positive cases in tonsils significantly increased from 2017 to 2023, while the proportion among non-tonsil OPSCCs remained constant. In a multivariate analysis, age, drinking, tumor sublocation, residential location of the patient, and N stage had a significant impact in HPV positivity.
conclusionsA large proportion of OPSCC was related to p16-positivity, which could be the possible cause. Our study reveals significant demographic and clinical variations based on p16 status, along with a noticeable upward trend in HPV-induced tumor prevalence, emphasizing the importance of vaccination programs in eastern China.
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