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Budhathoki S, Diergaarde B, Liu G, Olshan A, Ness A, Waterboer T, Virani S, Basta P, Bender N, Brenner N, Dudding T, Hayes N, Hope A, Huang SH, Hueniken K, Kanterewicz B, McKay JD, Pring M, Thomas S, Wisniewski K, Thomas S, Brhane Y, Agudo A, Alemany L, Lagiou A, Barzan L, Canova C, Conway DI, Healy CM, Holcatova I, Lagiou P, Macfarlane GJ, Macfarlane TV, Polesel J, Richiardi L, Robinson M, Znaor A, Brennan P, Hung RJ. A risk prediction model for head and neck cancers incorporating lifestyle factors, HPV serology and genetic markers. Int J Cancer 2023; 152:2069-2080. [PMID: 36694401 PMCID: PMC10006331 DOI: 10.1002/ijc.34444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Revised: 12/21/2022] [Accepted: 12/23/2022] [Indexed: 01/26/2023]
Abstract
Head and neck cancer is often diagnosed late and prognosis for most head and neck cancer patients remains poor. To aid early detection, we developed a risk prediction model based on demographic and lifestyle risk factors, human papillomavirus (HPV) serological markers and genetic markers. A total of 10 126 head and neck cancer cases and 5254 controls from five North American and European studies were included. HPV serostatus was determined by antibodies for HPV16 early oncoproteins (E6, E7) and regulatory early proteins (E1, E2, E4). The data were split into a training set (70%) for model development and a hold-out testing set (30%) for model performance evaluation, including discriminative ability and calibration. The risk models including demographic, lifestyle risk factors and polygenic risk score showed a reasonable predictive accuracy for head and neck cancer overall. A risk model that also included HPV serology showed substantially improved predictive accuracy for oropharyngeal cancer (AUC = 0.94, 95% CI = 0.92-0.95 in men and AUC = 0.92, 95% CI = 0.88-0.95 in women). The 5-year absolute risk estimates showed distinct trajectories by risk factor profiles. Based on the UK Biobank cohort, the risks of developing oropharyngeal cancer among 60 years old and HPV16 seropositive in the next 5 years ranged from 5.8% to 14.9% with an average of 8.1% for men, 1.3% to 4.4% with an average of 2.2% for women. Absolute risk was generally higher among individuals with heavy smoking, heavy drinking, HPV seropositivity and those with higher polygenic risk score. These risk models may be helpful for identifying people at high risk of developing head and neck cancer.
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Affiliation(s)
- Sanjeev Budhathoki
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Brenda Diergaarde
- Graduate School of Public Health, University of Pittsburgh, and UPMC Hillman Cancer Center, Pittsburgh, USA
| | - Geoffrey Liu
- Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Andrew Olshan
- University of North Carolina Lineberger Cancer Center, North Carolina, USA
| | - Andrew Ness
- NIHR Bristol Biomedical Research Centre, University of Bristol and Weston NHS Foundation Trust and University of Bristol, UK and Bristol Dental School, University of Bristol, Lower Maudlin St, Bristol, UK
- Bristol Dental School, University of Bristol, Lower Maudlin St, Bristol, UK
| | - Tim Waterboer
- Infections and Cancer Epidemiology Division, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Shama Virani
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Patricia Basta
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Noemi Bender
- Infections and Cancer Epidemiology Division, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Nicole Brenner
- Infections and Cancer Epidemiology Division, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Tom Dudding
- Bristol Dental School, University of Bristol, Lower Maudlin St, Bristol, UK
| | - Neil Hayes
- Division of Medical Oncology and Center for Cancer Research, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Andrew Hope
- Radiation Oncology, University of Toronto and Radiation Medicine Program, Princess Margaret Cancer Centre, University Health Network, Toronto, Canada
| | - Shao Hui Huang
- Radiation Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | - Katrina Hueniken
- Department of Medical Oncology, Princess Margaret Cancer Centre, University of Toronto, Toronto, Canada
| | | | - James D McKay
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Miranda Pring
- Bristol Dental School, University of Bristol, Lower Maudlin St, Bristol, UK
| | - Steve Thomas
- Bristol Dental School, University of Bristol, Lower Maudlin St, Bristol, UK
| | - Kathy Wisniewski
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Sera Thomas
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Yonathan Brhane
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
| | - Antonio Agudo
- Unit of Nutrition and Cancer, Catalan Institute of Oncology - ICO, L’Hospitalet de Llobregat, Spain
- Nutrition and Cancer Group; Epidemiology, Public Health, Cancer Prevention and Palliative Care Program; Bellvitge Biomedical Research Institute - IDIBELL, L’Hospitalet de Llobregat, Spain
| | | | - Areti Lagiou
- School of Public Health, University of West Attica, Greece
| | | | - Cristina Canova
- Unit of Biostatistics, Epidemiology and Public Health, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padova, Italy
| | - David I. Conway
- School of Medicine, Dentistry, and Nursing, University of Glasgow, UK
| | | | | | - Pagona Lagiou
- School of Medicine, National and Kapodistrian University of Athens, Greece
| | - Gary J. Macfarlane
- Epidemiology Group. School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Tatiana V. Macfarlane
- Epidemiology Group. School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | | | - Lorenzo Richiardi
- University of Turin and Reference Centre for Epidemiology and Cancer Prevention in Piemonte, Italy
| | - Max Robinson
- Centre for Oral Health Research, Newcastle University, UK
| | - Ariana Znaor
- International Agency for Research on cancer, France
| | - Paul Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - Rayjean J. Hung
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
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Adebamowo SN, Adeyemo AA, Rotimi CN, Olaniyan O, Offiong R, Adebamowo CA. Genome-wide association study of prevalent and persistent cervical high-risk human papillomavirus (HPV) infection. BMC MEDICAL GENETICS 2020; 21:231. [PMID: 33225922 PMCID: PMC7682060 DOI: 10.1186/s12881-020-01156-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2019] [Accepted: 10/25/2020] [Indexed: 01/20/2023]
Abstract
Background Genetic factors may influence the susceptibility to high-risk (hr) human papillomavirus (HPV) infection and persistence. We conducted the first genome-wide association study (GWAS) to identify variants associated with cervical hrHPV infection and persistence. Methods Participants were 517 Nigerian women evaluated at baseline and 6 months follow-up visits for HPV. HPV was characterized using SPF10/LiPA25. hrHPV infection was positive if at least one carcinogenic HPV genotype was detected in a sample provided at the baseline visit and persistent if at least one carcinogenic HPV genotype was detected in each of the samples provided at the baseline and follow-up visits. Genotyping was done using the Illumina Multi-Ethnic Genotyping Array (MEGA) and imputation was done using the African Genome Resources Haplotype Reference Panel. Association analysis was done for hrHPV infection (125 cases/392 controls) and for persistent hrHPV infection (51 cases/355 controls) under additive genetic models adjusted for age, HIV status and the first principal component (PC) of the genotypes. Results The mean (±SD) age of the study participants was 38 (±8) years, 48% were HIV negative, 24% were hrHPV positive and 10% had persistent hrHPV infections. No single variant reached genome-wide significance (p < 5 X 10− 8). The top three variants associated with hrHPV infections were intronic variants clustered in KLF12 (all OR: 7.06, p = 1.43 × 10− 6). The top variants associated with cervical hrHPV persistence were in DAP (OR: 6.86, p = 7.15 × 10− 8), NR5A2 (OR: 3.65, p = 2.03 × 10− 7) and MIR365–2 (OR: 7.71, p = 2.63 × 10− 7) gene regions. Conclusions This exploratory GWAS yielded suggestive candidate risk loci for cervical hrHPV infection and persistence. The identified loci have biological annotation and functional data supporting their role in hrHPV infection and persistence. Given our limited sample size, larger discovery and replication studies are warranted to further characterize the reported associations. Supplementary Information The online version contains supplementary material available at 10.1186/s12881-020-01156-1.
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Affiliation(s)
- Sally N Adebamowo
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood Street, Howard Hall, Room 119, Baltimore, MD, 21201, USA. .,University of Maryland Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Adebowale A Adeyemo
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Charles N Rotimi
- Center for Research on Genomics and Global Health, National Human Genome Research Institute, National Institutes of Health, Bethesda, MD, USA
| | - Olayinka Olaniyan
- Department of Obstetrics and Gynecology, National Hospital Abuja, Abuja, Nigeria
| | - Richard Offiong
- Department of Obstetrics and Gynecology, University of Abuja Teaching Hospital, Abuja, Nigeria
| | - Clement A Adebamowo
- Department of Epidemiology and Public Health, University of Maryland School of Medicine, 660 West Redwood Street, Howard Hall, Room 119, Baltimore, MD, 21201, USA.,University of Maryland Greenebaum Comprehensive Cancer Center, University of Maryland School of Medicine, Baltimore, MD, USA.,Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA.,Institute of Human Virology Nigeria, Abuja, Nigeria
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