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- Title
Distinct Risk Factor Profiles for Human Papillomavirus Type 16-Positive and Human Papillomavirus Type 16-Negative Head and Neck Cancers.
- Authors
Gillison, Maura L.; D'Souza, Gypsyamber; Westra, William; Sugar, Elizabeth; Weihong Xiao; Begum, Shahnaz; Viscidi, Raphael
- Abstract
Background High-risk types of human papillomavirus (HPV), including HPV-16, cause a subgroup of head and neck squamous cell carcinomas (HNSCCs). We examined whether the risk factors for HPV-16-positive HNSCCs are similar to those for HPV-16-negative HNSCCs in a hospital-based case-control study. Methods Case subjects (n = 240) diagnosed with HNSCC at the Johns Hopkins Hospital from 2000 through 2006 were stratified by tumor HPV-16 status as determined by in situ hybridization. Two control subjects (n = 322) without cancer were individually matched by age and sex to each HPV-16-positive and HPV-16- negative case subject. Data on risk behaviors were obtained by use of audio computer-assisted self-interview technology. Multivariable conditional logistic regression models were used to estimate the odds ratios (ORs) for HPV-16-positive HNSCC and HPV-16-negative HNSCC associated with risk factors. All statistical tests were two-sided. Results HPV-16 was detected in 92 of 240 case subjects. HPV-16-positive HNSCC was independently associated with several measures of sexual behavior and exposure to marijuana but not with cumulative measures of tobacco smoking, alcohol drinking, or poor oral hygiene. Associations increased in strength with increasing number of oral sex partners (Ptrend = .01) and with increasing intensity (joints per month, Ptrend = .007), duration (in years, Ptrend = .01), and cumulative joint-years (Ptrend = .003) of marijuana use. By contrast, HPV-16-negative HNSCC was associated with measures of tobacco smoking, alcohol drinking, and poor oral hygiene but not with any measure of sexual behavior or marijuana use. Associations increased in strength with increasing intensity (cigarettes per day), duration, and cumulative pack-years of tobacco smoking (for all, Ptrend < .001), increasing years of heavy alcohol drinking (≥15 years of 14 drinks per week; Ptrend = .03), and increasing number of lost teeth (Ptrend = .001). Compared with subjects who neither smoked tobacco nor drank alcohol, those with heavy use of tobacco (≥20 pack-years) and alcohol had an increased risk of HPV-16-negative HNSCC (OR = 4.8, 95% confidence interval [Cl] = 1.8 to 12) but not of HPV-16-positive HNSCC (OR = 0.67, 95% Cl = 0.29 to 1.9). Conclusions HPV-16-positive HNSCCs and HPV-16-negative HNSCCs have different risk factor profiles, indicating that they should be considered to be distinct cancers.
- Subjects
PAPILLOMAVIRUSES; HEAD &; neck cancer; SQUAMOUS cell carcinoma; CANCER risk factors; IN situ hybridization; REGRESSION analysis
- Publication
JNCI: Journal of the National Cancer Institute, 2008, Vol 100, Issue 6, p407
- ISSN
0027-8874
- Publication type
Article
- DOI
10.1093/jnci/djn025