Prognostic implications of human papillomavirus type 16 status in non-oropharyngeal head and neck cancer: a propensity score matching analysis

Globally, head and neck cancers accounted for an estimated 705,781 malignancies and 358,108 deaths in 2018 (1); combined, they are the sixth most common type of cancer worldwide, more than 90% of which is squamous cell carcinoma (2). Head and neck squamous cell carcinoma (HNSCC) is a heterogeneous disease occurring in various sites within the head and neck region, including the larynx, oropharynx, oral cavity, and hypopharynx. The most common risk factors are tobacco and alcohol use and high-risk human papillomavirus (HPV) infection (3,4). Although detection rates vary based on detection method and study populations, approximately 24.9% to 73.1% of patients with oropharyngeal squamous cell carcinomas (OPSCCs) and 6.1% to 28.8% of patients with non-oropharyngeal head and neck squamous cell carcinomas (non-OPSCCs), which include cancers of the larynx, oral cavity, and hypopharynx, are HPV-positive (5-10). Although several types of HPV have carcinogenic potential, the HPV 16 subtype accounts for more than 90% of HPV-positive HNSCCs (6,7,11,12)