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Satapathy P, Khatib MN, Gaidhane S, Zahiruddin QS, Serhan HA, Sharma RK, Sharma D, Arora M, Rustagi S, Na A, Alsayyah A, Al-Hajeili M, Al-Subaie MF, Alfaresi M, Alissa M, Rabaan AA. Prevalence of human papillomavirus in head and neck cancer patients in India: a systematic review and meta-analysis. BMC Infect Dis 2024; 24:516. [PMID: 38783184 PMCID: PMC11112865 DOI: 10.1186/s12879-024-09357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Accepted: 04/26/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND Human papillomavirus (HPV) is increasingly recognized as a significant risk factor in the development of head and neck cancers (HNCs), with varying prevalence and impact. This study aims to systematically review and analyze the prevalence of HPV in HNCs in India, providing insights into regional variations. METHODS A comprehensive literature search was carried out using PubMed, Embase, and Web of Science up to November 10, 2023. Inclusion criteria focused on original research reporting HPV-positive cases among HNC patients in India. We used Nested-Knowledge software, for screening, and data extraction. The modified Newcastle-Ottawa Scale was used for quality assessment of included studies. We pooled the prevalence of HPV among HNC patients and performed a random-effects model meta-analysis using R software (version 4.3). RESULTS The search yielded 33 studies, encompassing 4654 HNC patients. The pooled prevalence of HPV infection was found to be 33% (95% CI: 25.8-42.6), with notable heterogeneity (I² = 95%). Analysis of subgroups according to geographical location indicated varying prevalence rates. Specifically, the prevalence was 47% (95% CI: 32.2-62.4) in the eastern regions and 19.8% (95% CI: 10.8-33.4) in the western regions. No evidence of publication bias was detected. CONCLUSION The observed considerable regional disparities on the prevalence of HPV in HNC patients in India emphasizes the need for integrated HPV vaccination and screening programs in public health strategies. The findings underline the necessity for further research to explore regional variations and treatment responses in HPV-associated HNCs, considering the impact of factors such as tobacco use and the potential benefits of HPV vaccination.
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Affiliation(s)
- Prakasini Satapathy
- Center for Global Health Research, Saveetha Institute of Medical and Technical Sciences, Saveetha Medical College and Hospital, Saveetha University, Chennai, India.
- Medical Laboratories Techniques Department, AL-Mustaqbal University, Hillah, Babil, 51001, Iraq.
| | - Mahalaqua Nazli Khatib
- Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Shilpa Gaidhane
- One Health Centre (COHERD), Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education, Wardha, India
| | - Quazi Syed Zahiruddin
- Global South Asia Infant Feeding Research Network (SAIFRN), Division of Evidence Synthesis, Global Consortium of Public Health and Research, Datta Meghe Institute of Higher Education, Wardha, India
| | - Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporation, Doha, Qatar.
| | - Rakesh Kumar Sharma
- Graphic Era (Deemed to be University), Clement Town, Dehradun, India
- Graphic Era Hill University, Clement Town, Dehradun, India
| | - Divya Sharma
- Centre of Research Impact and Outcome, Chitkara University, Rajpura, 140417, Punjab, India
| | - Mithhil Arora
- Chitkara Centre for Research and Development, Chitkara University, Himachal Pradesh, 174103, India
| | - Sarvesh Rustagi
- School of Applied and Life Sciences, Uttaranchal University, Dehradun, Uttarakhand, India
| | - AlKaabi Na
- College of Medicine and Health Science, Khalifa University, 127788, Abu Dhabi, United Arab Emirates
- Sheikh Khalifa Medical City, Abu Dhabi Health Services Company (SEHA), 51900, Abu Dhabi, United Arab Emirates
| | - Ahmed Alsayyah
- Department of Pathology, College of Medicine, Imam Abdulrahman Bin Faisal University, 31441, Dammam, Saudi Arabia
| | - Marwan Al-Hajeili
- Department of Medicine, College of Medicine, King Abdulaziz University, 23624, Jeddah, Saudi Arabia
| | - Maha F Al-Subaie
- Research Center, Dr. Sulaiman Alhabib Medical Group, 13328, Riyadh, Saudi Arabia
- College of Medicine, Alfaisal University, 11533, Riyadh, Saudi Arabia
| | - Mubarak Alfaresi
- Department of Microbiology, National Reference laboratory, Cleveland clinic Abu Dhabi, 92323, Abu Dhabi, United Arab Emirates
- Department of Pathology, College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, 505055, Dubai, United Arab Emirates
| | - Mohammed Alissa
- Department of Medical Laboratory, College of Applied Medical Sciences, Prince Sattam bin Abdulaziz University, 11942, Al-Kharj, Saudi Arabia
| | - Ali A Rabaan
- College of Medicine, Alfaisal University, 11533, Riyadh, Saudi Arabia
- Molecular Diagnostic Laboratory, Johns Hopkins Aramco Healthcare, 31311, Dhahran, Saudi Arabia
- Department of Public Health and Nutrition, The University of Haripur, 22610, Haripur, Pakistan
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Vani NV, Rama R, Madhanagopal R, Vijayalakshmi R, Swaminathan R. Human Papillomavirus-Attributable Head and Neck Cancers in India-A Systematic Review and Meta-Analysis. JCO Glob Oncol 2024; 10:e2300464. [PMID: 38513185 PMCID: PMC10965205 DOI: 10.1200/go.23.00464] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 01/12/2024] [Accepted: 01/24/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE Head and neck cancer accounts for about one third of the global burden in India. Mucosal high-risk human papillomavirus (HPV) has been hypothesized as a contributory risk factor for head and neck cancer (HNC) but its prevalence in Indian patients is not well established. Therefore, this systematic review and meta-analysis aimed to estimate the prevalence of HPV in HNC in India and their attributable fraction by considering the biomarkers of carcinogenesis, p16, and HPV E6/E7 mRNA. METHODS A systematic literature search was done in Medline via PubMed, Embase, Scopus, ScienceDirect, ProQuest, and Cochrane to identify studies on HPV and HNC in the Indian population, published between January 1990 and October 2022. Fifty-four eligible studies were identified and relevant clinical information was collected. Meta-analysis was conducted to estimate the pooled prevalence of HPV DNA, p16INK4a, and E6/E7 mRNA percent positivity by random-effect logistic regression model using Metapreg, STATA 18. RESULTS Thirty-four high-quality studies were taken for meta-analysis. The pooled prevalence of HPV in HNC was 20% (95% CI, 12 to 32) with a high level of heterogeneity (I2 = 90.79%). The proportion of HPV in oropharyngeal cancer (OPC; 22% [95% CI, 13 to 34]) and laryngeal cancer (LC; 29% [95% CI, 17 to 46]) was higher than in oral cancer (OC; 16% [95% CI, 8 to 30]). The HPV-attributable fraction of OPC, considering the E6/E7 mRNA and p16 positivity, was 12.54% and 9.68%, respectively, almost similar to LC (11.6% and 9.57%), while it was much lower in OC (3.36% and 4%). CONCLUSION The HPV-attributable fraction is considerably lower for OC, suggesting a negligible causative role of HPV in OC. A significant proportion of OPC and LC are attributed to HPV; however, their exact causative role is unclear because of the presence of other known risk factors.
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Affiliation(s)
| | - Ranganathan Rama
- Department of Epidemiology, Biostatistics and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | - Rajendran Madhanagopal
- Department of Epidemiology, Biostatistics and Tumour Registry, Cancer Institute (WIA), Chennai, India
| | | | - Rajaraman Swaminathan
- Department of Epidemiology, Biostatistics and Tumour Registry, Cancer Institute (WIA), Chennai, India
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Current Updates on Cancer-Causing Types of Human Papillomaviruses (HPVs) in East, Southeast, and South Asia. Cancers (Basel) 2021; 13:cancers13112691. [PMID: 34070706 PMCID: PMC8198295 DOI: 10.3390/cancers13112691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Revised: 05/23/2021] [Accepted: 05/25/2021] [Indexed: 12/13/2022] Open
Abstract
Simple Summary Among the over 200 human papillomavirus (HPV) genotypes identified, approximately 15 of them can cause human cancers. In this review, we provided an updated overview of the distribution of cancer-causing HPV genotypes by countries in East, Southeast and South Asia. Besides the standard screening and treatment methods employed in these regions, we unravel HPV detection methods and therapeutics utilised in certain countries that differ from other part of the world. The discrepancies may be partly due to health infrastructure, socio-economy and cultural diversities. Additionally, we highlighted the area lack of study, particularly on the oncogenicity of HPV genotype variants of high prevalence in these regions. Abstract Human papillomavirus (HPV) infection remains one of the most prominent cancer-causing DNA viruses, contributing to approximately 5% of human cancers. While association between HPV and cervical cancers has been well-established, evidence on the attribution of head and neck cancers (HNC) to HPV have been increasing in recent years. Among the cancer-causing HPV genotypes, HPV16 and 18 remain the major contributors to cancers across the globe. Nonetheless, the distribution of HPV genotypes in ethnically, geographically, and socio-economically diverse East, Southeast, and South Asia may differ from other parts of the world. In this review, we garner and provide updated insight into various aspects of HPV reported in recent years (2015–2021) in these regions. We included: (i) the HPV genotypes detected in normal cancers of the uterine cervix and head and neck, as well as the distribution of the HPV genotypes by geography and age groups; (ii) the laboratory diagnostic methods and treatment regimens used within these regions; and (iii) the oncogenic properties of HPV prototypes and their variants contributing to carcinogenesis. More importantly, we also unveil the similarities and discrepancies between these aspects, the areas lacking study, and the challenges faced in HPV studies.
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Sivakumar N, Narwal A, Kamboj M, Devi A, Kumar S, Bhardwaj R. Molecular and Immunohistochemical Cognizance of HPV16 in Oral Leukoplakia, Oral Squamous Cell Carcinoma and Oropharyngeal Squamous Cell Carcinoma. Head Neck Pathol 2021; 15:882-892. [PMID: 33646558 PMCID: PMC8385043 DOI: 10.1007/s12105-021-01309-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 02/11/2021] [Indexed: 11/28/2022]
Abstract
Prior studies have established the carcinogenic role of HPV16 and also demonstrated its unique biological behavior in cervical and oropharyngeal squamous cell carcinoma (OPSCC) but its role in oral leukoplakia (OL) and oral squamous cell carcinoma (OSCC) is not well explored. Therefore, in the present study, we assessed HPV16 prevalence using PCR and Anti-HPV16 antibodies for the first time and correlated its biological behavior using p16INK4a and Ki67 proliferation index (PI) in OL, OSCC, and OPSCC. This study included 63 subjects comprising of 25 OL, 26 OSCC, and 12 OPSCC cases. Exfoliated cells were collected and processed for PCR followed by immunohistochemistry with primary antibodies p16INK4a, Anti-HPV16, and Ki67. The expressions were evaluated and statistical analysis included Chi-square and Spearman's test. Cumulatively 37% (OL-7%, OSCC-14% & OPSCC-16%) of cases showed positive PCR expression. PCR positivity was observed to be significantly higher (p 0.00) in OPSCC (9/12) than OSCC (9/26) and OL (5/25) cases. Overall immunohistochemical expression of p16INK4a, Anti-HPV16, and Ki67 were significantly (p 0.02) higher in HPV16 (PCR) positive cases. HPV16 + OSCC cases showed higher grades of p16INK4a and Ki67 expression. We have demonstrated a prevalence of HPV16 in OL, OSCC, and OPSCC through PCR, which may be concluded as a gold standard for the detection of HPV16 DNA.
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Affiliation(s)
- N. Sivakumar
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana 124001 India
| | - Anjali Narwal
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana 124001 India
| | - Mala Kamboj
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana 124001 India
| | - Anju Devi
- Department of Oral Pathology and Microbiology, Post Graduate Institute of Dental Sciences, Rohtak, Haryana 124001 India
| | - Sanjay Kumar
- Department of Pathology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana 124001 India
| | - Rashmi Bhardwaj
- Centre for Medical Biotechnology, MDU, Rohtak, Haryana 124001 India
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Nandi S, Mandal A, Chhebbi M. The prevalence and clinicopathological correlation of human papillomavirus in head and neck squamous cell carcinoma in India: A systematic review article. Cancer Treat Res Commun 2020; 26:100301. [PMID: 33401132 DOI: 10.1016/j.ctarc.2020.100301] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/23/2020] [Accepted: 12/30/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Head and neck squamous cell carcinoma (HNSCC) pose a great danger to society and now we have shreds of evidence for Human Papillomavirus (HPV) being one of the major causative agents for it. Though the prevalence of HPV varies throughout the world, it is gradually on the rise. The present systematic review aims to retrospect all the available studies on the prevalence of HPV in HNSCC in India and its clinicopathological aspect to study how it is different from HPV negative HNSCC. METHODS An objective electronic database search was conducted in PUBMED Central, MeSH, NLM Catalog, Bookshelf, and PUBMED published in 25 years period from 1994 till 2019. A total of 33 articles were shortlisted for the present review. RESULTS Studies conducted across India show the prevalence of HPV in Head and Neck Cancers ranging from 0-86.6%. Some studies reported that HPV positive HNSCC is more common in younger age, presents with advanced stage disease, and more commonly presents with nodal metastasis. As opposed to western literature HPV positive HNSCC in India is associated with a well-differentiated tumor grade. There is no difference in treatment outcome and survival among HPV positive and negative HNSCC. CONCLUSION Exact prevalence of HPV in HNSCC is still doubtful but now we have some insight into it. The prevalence of HPV in Indian HNSCC patients has risen gradually but treatment outcome and survival may be poorer compared to other countries. However definite conclusions cannot be drawn without proper prospective study.
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Affiliation(s)
- Sourabh Nandi
- Department of Surgical Oncology, All India Institute of Medical Sciences, India.
| | - Amitabha Mandal
- Department of Surgical Oncology, All India Institute of Medical Sciences, India.
| | - Madiwalesh Chhebbi
- Department of Surgical Oncology, All India Institute of Medical Sciences, India.
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Purwanto DJ, Soedarsono N, Reuwpassa JO, Adisasmita AC, Ramli M, Djuwita R. The prevalence of oral high‐risk HPV infection in Indonesian oral squamous cell carcinoma patients. Oral Dis 2019; 26:72-80. [DOI: 10.1111/odi.13221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 10/22/2019] [Accepted: 10/22/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Denni J. Purwanto
- Department of Surgical Oncology Dharmais National Cancer Hospital Jakarta Indonesia
| | - Nurtami Soedarsono
- Department of Oral Biology Faculty of Dentistry Universitas Indonesia Jakarta Indonesia
| | - Jauhari O. Reuwpassa
- Department of Surgical Oncology Dharmais National Cancer Hospital Jakarta Indonesia
| | - Asri C. Adisasmita
- Department of Epidemiology Faculty of Public Health Universitas Indonesia Depok Indonesia
| | - Muchlis Ramli
- Department of Surgical Oncology Cipto Mangunkusumo National Hospital‐Faculty of Medicine Universitas Indonesia Jakarta Indonesia
| | - Ratna Djuwita
- Department of Epidemiology Faculty of Public Health Universitas Indonesia Depok Indonesia
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Prevalence and Impact of Human Papillomavirus on Head and Neck Cancers: Review of Indian Studies. Indian J Surg Oncol 2018; 9:568-575. [PMID: 30538390 DOI: 10.1007/s13193-018-0813-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Accepted: 08/22/2018] [Indexed: 12/11/2022] Open
Abstract
Human papillomavirus (HPV) is an important emerging etiology for head and neck cancers (HNCs) worldwide. Considering its impact on prognosis, it is important to understand the true prevalence of HPV-associated HNCs in India. This article reviews the prevalence of HPV-related HNCs across various studies in India where the population is predominantly tobacco users, and studies its outcomes with respect to HPV.
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Thammaiah S, Venkobarao MC, Sathyavanthan H, Mirnalini AS. Quantitative polymerase chain reaction-based detection of HPV 16 E6 and E7 DNA in oral squamous cell carcinoma. J Oral Pathol Med 2018; 47:873-879. [PMID: 30059164 DOI: 10.1111/jop.12770] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Revised: 07/17/2018] [Accepted: 07/26/2018] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although human papillomavirus (HPV) is considered as a causative factor in oral squamous cell carcinoma (OSCCs), its pathogenetic role is not well established. Moreover, a limited number of studies have compared the techniques of detecting the HPV infection in OSCC. This study aimed at the detection of HPV 16 E6 and E7 DNA in OSCC by quantitative polymerase chain reaction (qPCR) technique. METHODOLOGY This retrospective study included 297 tissue sections obtained from histopathologically confirmed OSCC patients. The classification of tumors as poorly differentiated, moderately differentiated and well differentiated was performed by H&E staining following the WHO criteria for OSCC. The presence of HPV infection was detected by p16INK4A expression, conventional PCR technique, HPV 16 E6, and E7 by qPCR and flow cytometry. All statistical analysis was performed using MedCalc software v.16.4.3. P < 0.05 is considered as statistically significant. RESULTS Of 297 samples, 128 samples were found to be HPV-positive by p16. Of total 128 HPV-positive samples, PCR, E6, and E7 qPCR were positive in 19, 97, and 98 samples, respectively. qPCR techniques were found highly significant in the detection of moderately differentiated (P < 0.0001) and widely differentiated (P < 0.0001) cases. The positivity of E6 qPCR increased as the p16 expression increased. A significant variation in E6 DNA copies was observed in different grades of p16 expression (P < 0.0001). However, overall E7 (5.4 × 105 copies/μL) DNA copies were higher than E6 (7.7 × 103 copies/μL). CONCLUSION qPCR detection of HPV infection is a fast, reliable, and accurate technique gives valuable information about the infection status in terms of viral load.
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Affiliation(s)
- Smitha Thammaiah
- Department of Oral Pathology, VS Dental College and Hospital, Bengaluru, Karnataka, India
| | | | - Hemavathy Sathyavanthan
- Department of Oral Pathology, Sri Rajiv Gandhi College of Dental Science, Bengaluru, Karnataka, India
| | - Angeline S Mirnalini
- Department of Oral Pathology, VS Dental College and Hospital, Bengaluru, Karnataka, India
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