Epidemiol ogy of human papillom a virus associated oropharyn -geal cancer in England and Wales: Recent UK estimates in the last decade from the (PET-NECK) randomised controlled trial

Purpose: Increasing evidence shows that human papilloma virus (HPV) is responsible for a distinct sub-group of oropharyngeal Cancers (OPCs). We aim to characte rise the unknown burden of HPV-related OPCs in the United Kingdom and determine its relationship by region with age, gender, tumour stage, and risk factors. Materials and methods: Prospective data was obtained from 218 patients with histological ly confirmed OPC treated in two head and neck centres in the time period 2001-2011. HPV DNA detection was determined using polyme rase chain reaction with a cocktail of HPV-spe cific for 14 high-risk and 6 low-risk probes and p16 immu-nohistochemistry. HPV positivity was defined as both p16-positive and HPV DNA-positive. Additional data on demograp hics, smoking history and clinical stage of diagnosis were collected and its association with HPV-OPCs was evaluated. Statistical analysis was performed using STATA. Results: 218 samples of OPCs were obtained from Coventry (n = 58) and Wales (n = 160). Median age of OPCs was 57 years (range 33-87 years). The majority of OPC cases were male (77.5%). 117 (53.7%) OPCs were p16-p ositive, 120 (44.0%) were HPV DNApositive and 106 (48.6%) were both p16-positive / HPV-positive. Compared to HPV-negative OPCs, HPV-posi tive OPCs were more likely to be P60 years (32.1% vs. 53.6%, respect ively), late stage tumours (T3/T4) (37.7% vs. 57.1%, respectively). The prevalence of HPV-OPCs increased from 38.9% in (2000-2004) to 57% in (2005- 2009), and to 100% in (2010-2011). Conclusion: This study demonstrates that annual number of HPV + OPC cases has more than quadrupled over the last decade in the UK. Graph by year of HPV+ proportion.