Role of mucosal high-risk human papillomavirus types in head and neck cancers in central India

Int J Cancer. 2017 Jul 1;141(1):143-151. doi: 10.1002/ijc.30712. Epub 2017 Apr 19.


Mucosal high-risk (HR) human papillomaviruses (HPV) cause a subset of head and neck cancers (HNC). The HPV-attributable fraction of HNC varies substantially between countries. Although HNC has a very high incidence in the Indian subcontinent, information on the contribution of HPV infection is limited. Here, we evaluated the HPV-attributable fraction in HNC (N = 364) collected in a central region of India. HNC from three different anatomical subsites were included, namely, oral cavity (n = 252), oropharynx (n = 53) and hypopharynx/larynx (n = 59). In this retrospective study, HPV-driven HNC were defined by presence of both viral DNA and RNA. Overexpression of p16INK4a was also evaluated. HR-HPV DNA was detected in 13.7% of the cases; however, only 2.7% were positive for both HPV DNA and RNA. The highest percentage of HPV DNA/RNA double positivity was found in oropharynx (9.4%), followed by larynx (1.7%) and oral cavity (1.6%) (p = 0.02). More than half of HPV DNA/RNA-positive cases were p16INK4a -negative, while a considerable number of HPV RNA-negative cases were p16INK4a -positive (17.9%). HPV16 was the major type associated with HNC (60.0%), although cases positive for HPV18, 35 and 56 were also detected. Our data indicate that the proportion and types of mucosal HR-HPV associated with HNC in this central Indian region differ from those in other (developed) parts of the world. This may be explained by differences in smoking and/or sexual behaviour compared with North America and northern Europe. Moreover, we show that p16INK4a staining appeared not to be a good surrogate marker of HPV transformation in the Indian HNC cases.

Keywords: HPV; central India; head and neck cancer.

MeSH terms

  • Adult
  • Aged
  • Cyclin-Dependent Kinase Inhibitor p16 / genetics
  • Female
  • Head and Neck Neoplasms / epidemiology*
  • Head and Neck Neoplasms / genetics
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / virology*
  • Humans
  • India / epidemiology
  • Male
  • Middle Aged
  • Papillomaviridae / classification
  • Papillomaviridae / genetics
  • Papillomaviridae / pathogenicity*
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / genetics
  • Papillomavirus Infections / pathology
  • Papillomavirus Infections / virology*


  • CDKN2A protein, human
  • Cyclin-Dependent Kinase Inhibitor p16