{"id":5485,"date":"2008-03-12T12:24:45","date_gmt":"2008-03-12T19:24:45","guid":{"rendered":"http:\/\/oralcancernews.org\/wp\/?p=5485"},"modified":"2009-04-16T12:25:22","modified_gmt":"2009-04-16T19:25:22","slug":"distinct-risk-factor-profiles-for-hpv-16-positive-and-hpv-16-negative-head-and-neck-cancers","status":"publish","type":"post","link":"https:\/\/oralcancernews.org\/wp\/distinct-risk-factor-profiles-for-hpv-16-positive-and-hpv-16-negative-head-and-neck-cancers\/","title":{"rendered":"Distinct Risk Factor Profiles for HPV 16 Positive and HPV 16 Negative Head and Neck Cancers"},"content":{"rendered":"<ul class=\"bullets\">\n<li><strong>3\/12\/2008<\/strong><\/li>\n<li><strong>Marua Gillison MD et. al<\/strong><\/li>\n<li><strong>Journal of the National Cancer Institute<\/strong><\/li>\n<\/ul>\n<p>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\u2013positive HNSCCs are similar to those for HPV-16\u2013negative HNSCCs in a hospital-based case\u2013control study.<\/p>\n<p>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\u2013positive and HPV-16\u2013negative 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\u2013positive HNSCC and HPV-16\u2013negative HNSCC associated with risk factors. All statistical tests were two-sided.<\/p>\n<p>Results: HPV-16 was detected in 92 of 240 case subjects. HPV-16\u2013positive 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\u2013negative 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 &lt; .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\u2013negative HNSCC (OR = 4.8, 95% confidence interval [CI] = 1.8 to 12) but not of HPV-16\u2013positive HNSCC (OR = 0.67, 95% CI = 0.29 to 1.9).<\/p>\n<p>Conclusions: HPV-16\u2013positive HNSCCs and HPV-16\u2013negative HNSCCs have different risk factor profiles, indicating that they should be considered to be distinct cancers.<\/p>\n<p>CONTEXT AND CAVEATS<\/p>\n<p>Prior knowledge<br \/>\nHigh-risk types of human papillomavirus (HPV), including HPV-16, cause a subgroup of head and neck squamous cell carcinomas (HNSCCs), but it is unclear whether the risk factors for HPV-16\u2013positive HNSCCs are similar to those for HPV-16\u2013negative HNSCCs.<\/p>\n<p>Study design<br \/>\nA hospital-based case\u2013control study of HNSCC to compare the risk factor profiles for HPV-16\u2013positive and HPV-16\u2013negative HNSCCs.<\/p>\n<p>Contribution<br \/>\nHPV-16\u2013positive 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. HPV-16\u2013negative HNSCC was associated with measures of tobacco smoking, alcohol drinking, and poor oral hygiene but not with any measures of sexual behavior or marijuana use.<\/p>\n<p>Implications<br \/>\nHNSCCs are a heterogeneous group of malignancies with at least two etiologically distinct pathways for HNSCC pathogenesis, one mediated by tobacco and alcohol and the other by HPV.<\/p>\n<p>Limitations<br \/>\nThe use of HPV-16 in situ hybridization alone to stratify cases as HPV-positive or HPV-negative may have misclassified tumor HPV status. The control population may not adequately represent the true prevalence of exposures of interest in the general population. Differential recall bias among case subjects, residual confounding by sexual behavior, or possible confounding by use of other substances could have influenced observed associations between marijuana use and HPV-16\u2013positive HNSCC.<\/p>\n<p>Authors: Maura L. Gillison, Gypsyamber D&#8217;Souza, William Westra, Elizabeth Sugar, Weihong Xiao, Shahnaz Begum, Raphael Viscidi<br \/>\nAffiliations of authors: Divisions of Viral Oncology (MLG, WX) and Biometry and Oncology Biostatistics (ES), The Johns Hopkins Kimmel Comprehensive Cancer Center, Baltimore, MD; Department of Epidemiology, The Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (GDS); Departments of Pathology (WW, SB) and Pediatrics (RV), Johns Hopkins Hospital, Baltimore, MD<\/p>\n<p>Correspondence to: Maura L. Gillison, MD, PhD, Johns Hopkins Medical Institutions, CRB I Rm 3M 54A, 1650 Orleans St, Baltimore, MD 21231 (e-mail: gillima@jhmi.edu).<\/p>\n","protected":false},"excerpt":{"rendered":"<p>3\/12\/2008 Marua Gillison MD et. al Journal of the National Cancer Institute 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\u2013positive HNSCCs are similar to those for HPV-16\u2013negative HNSCCs in a hospital-based case\u2013control 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\u2013positive and HPV-16\u2013negative 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\u2013positive HNSCC and HPV-16\u2013negative HNSCC associated with risk factors. All statistical tests were two-sided. Results: HPV-16 was detected in 92 of 240 case subjects. HPV-16\u2013positive 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\u2013negative HNSCC was associated with measures of tobacco smoking, alcohol drinking, and poor oral hygiene but not with any measure of sexual behavior or  [&#8230;]<\/p>\n","protected":false},"author":41,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[787],"tags":[],"class_list":["post-5485","post","type-post","status-publish","format-standard","hentry","category-oral-cancer-news-archive"],"_links":{"self":[{"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/posts\/5485","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/users\/41"}],"replies":[{"embeddable":true,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/comments?post=5485"}],"version-history":[{"count":1,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/posts\/5485\/revisions"}],"predecessor-version":[{"id":5486,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/posts\/5485\/revisions\/5486"}],"wp:attachment":[{"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/media?parent=5485"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/categories?post=5485"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/oralcancernews.org\/wp\/wp-json\/wp\/v2\/tags?post=5485"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}