TY - JOUR
T1 - Absolute Risk of Oropharyngeal Cancer After an HPV16-E6 Serology Test and Potential Implications for Screening
T2 - Results From the Human Papillomavirus Cancer Cohort Consortium
AU - Robbins, Hilary A.
AU - Ferreiro-Iglesias, Aida
AU - Waterboer, Tim
AU - Brenner, Nicole
AU - Nygard, Mari
AU - Bender, Noemi
AU - Schroeder, Lea
AU - Hildesheim, Allan
AU - Pawlita, Michael
AU - D'souza, Gypsyamber
AU - Visvanathan, Kala
AU - Langseth, Hilde
AU - Schlecht, Nicolas F.
AU - Tinker, Lesley F.
AU - Agalliu, Ilir
AU - Wassertheil-Smoller, Sylvia
AU - Ness-Jensen, Eivind
AU - Hveem, Kristian
AU - Grioni, Sara
AU - Kaaks, Rudolf
AU - Sánchez, Maria Jose
AU - Weiderpass, Elisabete
AU - Giles, Graham G.
AU - Milne, Roger L.
AU - Cai, Qiuyin
AU - Blot, William J.
AU - Zheng, Wei
AU - Weinstein, Stephanie J.
AU - Albanes, Demetrius
AU - Huang, Wen Yi
AU - Freedman, Neal D.
AU - Kreimer, Aimée R.
AU - Johansson, Mattias
AU - Brennan, Paul
N1 - Publisher Copyright:
© American Society of Clinical Oncology.
PY - 2022/6/1
Y1 - 2022/6/1
N2 - PURPOSESeropositivity for the HPV16-E6 oncoprotein is a promising marker for early detection of oropharyngeal cancer (OPC), but the absolute risk of OPC after a positive or negative test is unknown.METHODSWe constructed an OPC risk prediction model that integrates (1) relative odds of OPC for HPV16-E6 serostatus and cigarette smoking from the human papillomavirus (HPV) Cancer Cohort Consortium (HPVC3), (2) US population risk factor data from the National Health Interview Survey, and (3) US sex-specific population rates of OPC and mortality.RESULTSThe nine HPVC3 cohorts included 365 participants with OPC with up to 10 years between blood draw and diagnosis and 5,794 controls. The estimated 10-year OPC risk for HPV16-E6 seropositive males at age 50 years was 17.4% (95% CI, 12.4 to 28.6) and at age 60 years was 27.1% (95% CI, 19.2 to 45.4). Corresponding 5-year risk estimates were 7.3% and 14.4%, respectively. For HPV16-E6 seropositive females, 10-year risk estimates were 3.6% (95% CI, 2.5 to 5.9) at age 50 years and 5.5% (95% CI, 3.8 to 9.2) at age 60 years and 5-year risk estimates were 1.5% and 2.7%, respectively. Over 30 years, after a seropositive result at age 50 years, an estimated 49.9% of males and 13.3% of females would develop OPC. By contrast, 10-year risks among HPV16-E6 seronegative people were very low, ranging from 0.01% to 0.25% depending on age, sex, and smoking status.CONCLUSIONWe estimate that a substantial proportion of HPV16-E6 seropositive individuals will develop OPC, with 10-year risks of 17%-27% for males and 4%-6% for females age 50-60 years in the United States. This high level of risk may warrant periodic, minimally invasive surveillance after a positive HPV16-E6 serology test, particularly for males in high-incidence regions. However, an appropriate clinical protocol for surveillance remains to be established.
AB - PURPOSESeropositivity for the HPV16-E6 oncoprotein is a promising marker for early detection of oropharyngeal cancer (OPC), but the absolute risk of OPC after a positive or negative test is unknown.METHODSWe constructed an OPC risk prediction model that integrates (1) relative odds of OPC for HPV16-E6 serostatus and cigarette smoking from the human papillomavirus (HPV) Cancer Cohort Consortium (HPVC3), (2) US population risk factor data from the National Health Interview Survey, and (3) US sex-specific population rates of OPC and mortality.RESULTSThe nine HPVC3 cohorts included 365 participants with OPC with up to 10 years between blood draw and diagnosis and 5,794 controls. The estimated 10-year OPC risk for HPV16-E6 seropositive males at age 50 years was 17.4% (95% CI, 12.4 to 28.6) and at age 60 years was 27.1% (95% CI, 19.2 to 45.4). Corresponding 5-year risk estimates were 7.3% and 14.4%, respectively. For HPV16-E6 seropositive females, 10-year risk estimates were 3.6% (95% CI, 2.5 to 5.9) at age 50 years and 5.5% (95% CI, 3.8 to 9.2) at age 60 years and 5-year risk estimates were 1.5% and 2.7%, respectively. Over 30 years, after a seropositive result at age 50 years, an estimated 49.9% of males and 13.3% of females would develop OPC. By contrast, 10-year risks among HPV16-E6 seronegative people were very low, ranging from 0.01% to 0.25% depending on age, sex, and smoking status.CONCLUSIONWe estimate that a substantial proportion of HPV16-E6 seropositive individuals will develop OPC, with 10-year risks of 17%-27% for males and 4%-6% for females age 50-60 years in the United States. This high level of risk may warrant periodic, minimally invasive surveillance after a positive HPV16-E6 serology test, particularly for males in high-incidence regions. However, an appropriate clinical protocol for surveillance remains to be established.
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U2 - 10.1200/JCO.21.01785
DO - 10.1200/JCO.21.01785
M3 - Article
C2 - 35700419
AN - SCOPUS:85139787220
SN - 0732-183X
VL - 2
JO - Journal of Clinical Oncology
JF - Journal of Clinical Oncology
M1 - JCO.21.01785
ER -