Abstract
Purpose
Recently, human papillomavirus (HPV) infection has been causally associated with a subset of head and neck cancers, particularly oropharyngeal cancer. As national cancer reporting systems typically report incidence rates of oropharyngeal cancer grouped with other cancers of the head and neck region, the objective of this study was to present age-standardized incidence trends in oropharyngeal cancer Canada-wide.
Methods
Data were obtained from the Canadian Cancer Registry for cases diagnosed between 1992 and 2009. Trends in age-standardized incidence rates were described for head and neck cancers overall and for HPV-associated oropharyngeal cancer using Joinpoint regression.
Results
The age-standardized incidence of head and neck cancers declined significantly in Canada from 1992 to 1998 (annual percentage change [APC] = −3.0, p < 0.01), then remained stable through to 2009. In contrast, the age-standardized incidence of HPV-associated oropharyngeal cancer increased significantly during the same time period, from 1.6 per 100,000 in 1992 to 2.6 in 2009 (APC = 2.7, p < 0.001). The increase in HPV-associated oropharyngeal cancer was greater in males than in females and increased significantly in all age groups, particularly those aged 50–59 (APC = 5.4, p < 0.001). The age-standardized incidence rate of head and neck cancer overall was stable or declined in all age groups except those aged 50–59 where incidence decreased from 1992 to 1997, then increased through to 2009.
Conclusions
The incidence patterns of HPV-associated oropharyngeal cancer and head and neck cancer overall show contrasting trends. Findings highlight the need to surveil HPV-associated oropharyngeal cancer separately from other cancers of the head and neck region in order to monitor these emerging trends.
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References
Canadian Cancer Society’s Steering Committee on Cancer Statistics (2011) Canadian cancer statistics 2011. Canadian Cancer Society, Toronto
Reid JL, Hammond D (2009) Tobacco use in Canada: patterns and trends, 2009, v2 edn. Propel Centre for Population Health Impact, University of Waterloo, Waterloo, ON
Parkin DM, Bray F (2006) Chapter 2: the burden of HPV-related cancers. Vaccine 24(Suppl 3):11–25
Syrjanen K, Syrjanen S, Lamberg M, Pyrhonen S, Nuutinen J (1983) Morphological and immunohistochemical evidence suggesting human papillomavirus (HPV) involvement in oral squamous cell carcinogenesis. Int J Oral Surg 12(6):418–424
Snijders PJ, Cromme FV, van den Brule AJ, Schrijnemakers HF, Snow GB, Meijer CJ et al (1992) Prevalence and expression of human papillomavirus in tonsillar carcinomas, indicating a possible viral etiology. Int J Cancer 51(6):845–850
Niedobitek G, Pitteroff S, Herbst H, Shepherd P, Finn T, Anagnostopoulos I et al (1990) Detection of human papillomavirus type 16 DNA in carcinomas of the palatine tonsil. J Clin Pathol 43(11):918–921
Gillison ML, Koch WM, Capone RB, Spafford M, Westra WH, Wu L et al (2000) Evidence for a causal association between human papillomavirus and a subset of head and neck cancers. J Natl Cancer Inst 92(9):709–720
Kreimer AR, Clifford GM, Boyle P, Franceschi S (2005) Human papillomavirus types in head and neck squamous cell carcinomas worldwide: a systematic review. Cancer Epidemiol Biomarkers Prev 14(2):467–475
Mork J, Lie AK, Glattre E, Hallmans G, Jellum E, Koskela P et al (2001) Human papillomavirus infection as a risk factor for squamous-cell carcinoma of the head and neck. N Engl J Med 344(15):1125–1131
D’Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch WM et al (2007) Case–control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 356(19):1944–1956
Pintos J, Black MJ, Sadeghi N, Ghadirian P, Zeitouni AG, Viscidi RP et al (2008) Human papillomavirus infection and oral cancer: a case–control study in Montreal, Canada. Oral Oncol 44(3):242–250
IARC (2007) IARC monographs on the evaluation of carcinogenic risks to humans. Human papillomaviruses, vol 90. IARC, Lyon
Chaturvedi AK, Engels EA, Anderson WF, Gillison ML (2008) Incidence trends for human papillomavirus-related and -unrelated oral squamous cell carcinomas in the United States. J Clin Oncol 26(4):612–619
Syrjanen S (2004) HPV infections and tonsillar carcinoma. J Clin Pathol 57(5):449–455
Frisch M, Hjalgrim H, Jaeger AB, Biggar RJ (2000) Changing patterns of tonsillar squamous cell carcinoma in the United States. Cancer Causes Control 11(6):489–495
Shiboski CH, Schmidt BL, Jordan RC (2005) Tongue and tonsil carcinoma: increasing trends in the U.S. population ages 20–44 years. Cancer 103(9):1843–1849
Robinson KL, Macfarlane GJ (2003) Oropharyngeal cancer incidence and mortality in Scotland: are rates still increasing? Oral Oncol 39(1):31–36
Hammarstedt L, Lindquist D, Dahlstrand H, Romanitan M, Dahlgren LO, Joneberg J et al (2006) Human papillomavirus as a risk factor for the increase in incidence of tonsillar cancer. Int J Cancer 119(11):2620–2623
Conway DI, Stockton DL, Warnakulasuriya KA, Ogden G, Macpherson LM (2006) Incidence of oral and oropharyngeal cancer in United Kingdom (1990–1999)—recent trends and regional variation. Oral Oncol 42(6):586–592
Braakhuis BJ, Visser O, Leemans CR (2009) Oral and oropharyngeal cancer in The Netherlands between 1989 and 2006: increasing incidence, but not in young adults. Oral Oncol 45(9):e85–e89
Hocking JS, Stein A, Conway EL, Regan D, Grulich A, Law M et al (2011) Head and neck cancer in Australia between 1982 and 2005 show increasing incidence of potentially HPV-associated oropharyngeal cancers. Br J Cancer 104(5):886–891
Auluck A, Hislop G, Bajdik C, Poh C, Zhang L, Rosin M (2010) Trends in oropharyngeal and oral cavity cancer incidence of human papillomavirus (HPV)-related and HPV-unrelated sites in a multicultural population: the British Columbia experience. Cancer 116(11):2635–2644
Cancer Care Ontario (2011) HPV-related oral cancers increasing among Ontario men 2011 Contract no.: July 2011
Howlader N, Noone A, Krapcho M, Neyman N, Aminou R, Waldron W et al (2010) SEER cancer statistics review 1975–2008. National Cancer Institute, Bethesda; available from: http://seer.cancer.gov/csr/1975_2008/
Cancer Research UK (2011) CancerStats—cancer statistics for the UK. London; available from: http://info.cancerresearchuk.org/cancerstats/
Ferlay J, Shin HR, Bray F, Forman D, C M, Parkin DM (2010) GLOBOCAN 1: cancer incidence and mortality worldwide: IARC CancerBase no. 10. International Agency for Research on Cancer, France; available from: http://globocan.iarc.fr
Statistics Canada (2012) Canadian Cancer Registry (CCR). Statistics Canada, Ottawa; available from: http://www23.statcan.gc.ca:81/imdb/p2SV.pl?Function=getSurvey&SDDS=3207#a3
Ernster JA, Sciotto CG, O’Brien MM, Finch JL, Robinson LJ, Willson T et al (2007) Rising incidence of oropharyngeal cancer and the role of oncogenic human papilloma virus. Laryngoscope 117(12):2115–2128
Chaturvedi AK, Engels EA, Pfeiffer RM, Hernandez BY, Xiao W, Kim E et al (2011) Human papillomavirus and rising oropharyngeal cancer incidence in the United States. J Clin Oncol 29(32):4294–4301
Turner CF, Danella RD, Rogers SM (1995) Sexual behavior in the United States 1930–1990: trends and methodological problems. Sex Transm Dis 22(3):173–190
Smith T (1998) American sexual behavior: trends, socio-demographic differences, and risk behavior. Report no. 25. University of Chicago, Chicago
Rosenquist K, Wennerberg J, Schildt EB, Bladstrom A, Goran Hansson B, Andersson G (2005) Oral status, oral infections and some lifestyle factors as risk factors for oral and oropharyngeal squamous cell carcinoma. A population-based case–control study in southern Sweden. Acta Otolaryngol 125(12):1327–1336
Heck JE, Berthiller J, Vaccarella S, Winn DM, Smith EM, Shan’gina O et al (2010) Sexual behaviours and the risk of head and neck cancers: a pooled analysis in the International Head and Neck Cancer Epidemiology (INHANCE) consortium. Int J Epidemiol 39(1):166–181
Smith EM, Ritchie JM, Summersgill KF, Klussmann JP, Lee JH, Wang D et al (2004) Age, sexual behavior and human papillomavirus infection in oral cavity and oropharyngeal cancers. Int J Cancer 108(5):766–772
Marur S, D’Souza G, Westra WH, Forastiere AA (2010) HPV-associated head and neck cancer: a virus-related cancer epidemic. Lancet Oncol 11(8):781–789
Mellin H, Friesland S, Lewensohn R, Dalianis T, Munck-Wikland E (2000) Human papillomavirus (HPV) DNA in tonsillar cancer: clinical correlates, risk of relapse, and survival. Int J Cancer 89(3):300–304
Lindquist D, Romanitan M, Hammarstedt L, Nasman A, Dahlstrand H, Lindholm J et al (2007) Human papillomavirus is a favourable prognostic factor in tonsillar cancer and its oncogenic role is supported by the expression of E6 and E7. Mol Oncol 1(3):350–355
Ang KK, Harris J, Wheeler R, Weber R, Rosenthal DI, Nguyen-Tan PF et al (2010) Human papillomavirus and survival of patients with oropharyngeal cancer. N Engl J Med 363(1):24–35
Gillison ML, D’Souza G, Westra W, Sugar E, Xiao W, Begum S et al (2008) Distinct risk factor profiles for human papillomavirus type 16-positive and human papillomavirus type 16-negative head and neck cancers. J Natl Cancer Inst 100(6):407–420
Public Health Agency of Canada (2007) National Advisory Committee on Immunization (NACI) statement on humanpapillomavirus vaccine. Public Health Agency of Canada, Ottawa
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This document has been made possible through a financial contribution from Health Canada, through the Canadian Partnership Against Cancer.
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Forte, T., Niu, J., Lockwood, G.A. et al. Incidence trends in head and neck cancers and human papillomavirus (HPV)-associated oropharyngeal cancer in Canada, 1992–2009. Cancer Causes Control 23, 1343–1348 (2012). https://doi.org/10.1007/s10552-012-0013-z
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DOI: https://doi.org/10.1007/s10552-012-0013-z