Human papillomavirus genotype and oropharynx cancer survival in the United States of America

Eur J Cancer. 2015 Dec;51(18):2759-67. doi: 10.1016/j.ejca.2015.09.005. Epub 2015 Nov 18.


Background: The presence of human papillomavirus (HPV) DNA in oropharyngeal squamous cell cancer (OPSCC) tissue appears to be a strong predictor of improved prognosis, but this observation has not been explored in a population-based sample with generalisable findings.

Methods: Follow-up data from a large sample of OPSCC patients identified through six population-based cancer registries in the United States of America (USA) were used to characterise the association of tumour HPV status with survival.

Results: HPV DNA was detected in tumour tissue from 71% (378 in 529) of the OPSCC patients. A total of 65% of patients with HPV16-associated tumours survived 5 years compared to 46% of patients with other HPV types and 28% of patients with HPV-negative tumours (p log-rank test <0.0001). The OPSCC patients with detectable HPV16 DNA had a 62% reduced hazard of death at 5 years, and patients with other HPV types had a 42% reduced hazard of death at 5 years compared to HPV-negative patients. Compared to non-Hispanic Whites, Blacks with OPSCC had a 2.6-fold greater risk of death at 5 years after adjustment for HPV status and other prognostic variables. Both surgery and radiation therapy were associated with a reduced 5-year risk of death, but no evidence was found for an interaction between HPV status and radiotherapy or surgery on survival time.

Conclusions: Data from this US study suggest that HPV16-positive OPSCC patients survive longer than HPV-negative patients regardless of treatment, highlighting the prognostic importance of HPV status for this malignancy. Optimal treatment regimens for OPSCC could be tailored to each patient's HPV status and prognostic profile.

Keywords: Archived tissue; Cancer of the oropharynx; Cancer registry; Human papillomavirus; Survival.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Carcinoma, Squamous Cell / diagnosis
  • Carcinoma, Squamous Cell / ethnology
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / therapy
  • Carcinoma, Squamous Cell / virology*
  • DNA, Viral / genetics*
  • Female
  • Genotype
  • Head and Neck Neoplasms / diagnosis
  • Head and Neck Neoplasms / ethnology
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / therapy
  • Head and Neck Neoplasms / virology*
  • Human Papillomavirus DNA Tests
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Oropharyngeal Neoplasms / diagnosis
  • Oropharyngeal Neoplasms / ethnology
  • Oropharyngeal Neoplasms / mortality
  • Oropharyngeal Neoplasms / therapy
  • Oropharyngeal Neoplasms / virology*
  • Papillomaviridae / genetics*
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / ethnology
  • Papillomavirus Infections / mortality
  • Papillomavirus Infections / virology*
  • Proportional Hazards Models
  • Racial Groups
  • Risk Factors
  • SEER Program
  • Squamous Cell Carcinoma of Head and Neck
  • Time Factors
  • Treatment Outcome
  • United States / epidemiology


  • DNA, Viral