Human papillomavirus associated oropharyngeal cancer now the most common mucosal head and neck cancer in Queensland

Sandro V Porceddu; Theresa Negrello; Neal Rawson; Nathan Dunn; Martin Batstone; Michael Collins; Sam Dowthwaite; Brett Gm Hughes; Liz Kenny; Rahul Ladwa; Ben Panizza; Danica Cossio

doi:10.1111/1754-9485.13643

Human papillomavirus associated oropharyngeal cancer now the most common mucosal head and neck cancer in Queensland

J Med Imaging Radiat Oncol. 2024 Apr 23. doi: 10.1111/1754-9485.13643. Online ahead of print.

Authors

Sandro V Porceddu^{1

2}, Theresa Negrello³, Neal Rawson³, Nathan Dunn^{2

3}, Martin Batstone^{2

4}, Michael Collins^{5

6}, Sam Dowthwaite^{7

8}, Brett Gm Hughes^{2

9}, Liz Kenny^{2

10}, Rahul Ladwa^{1

2}, Ben Panizza^{2

11}, Danica Cossio³

Affiliations

¹ Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
² Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
³ Queensland Cancer Control Analysis Team (QCCAT), Cancer Alliance Queensland, Brisbane, Queensland, Australia.
⁴ Department of Surgery, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
⁵ Department of Radiation Oncology, Townsville Hospital, Townsville, Queensland, Australia.
⁶ James Cook University, Townsville, Queensland, Australia.
⁷ Gold Coast University Hospital, Gold Coast, Queensland, Australia.
⁸ Griffith University, Gold Coast, Queensland, Australia.
⁹ Department of Medical Oncology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
¹⁰ Department of Radiation Oncology, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia.
¹¹ Department of Otolaryngology, Head and Neck Surgery, Princess Alexandra Hospital, Brisbane, Queensland, Australia.

PMID: 38654618
DOI: 10.1111/1754-9485.13643

Abstract

Introduction: The profile and outcomes of head and neck cancer throughout Australia has changed over the past decade. The aim of this study was to perform a population-based analysis of incidence, demographics, stage, treatments and outcomes of patients diagnosed with oropharyngeal squamous cell carcinoma (OPSCC), with a particular focus on HPV-associated disease.

Methods: This was a retrospective analysis of prospectively collected data within the Queensland Oncology Repository (QOR) and analysed by the Queensland Cancer Control Analysis Team. The cohort included patients diagnosed in Queensland between 1 January 2015 and 31 December 2019. Outcome measures included incidence of new OPSCC cases, age-standardised rates (ASR) (3-year average), demographics, p16 status, stage (8th Edition American Joint Commission on Cancer), treatments, and 2- and 5-year overall survival.

Results: There were 1527 newly diagnosed OPSCC, representing 96% (1527/1584) of all oropharyngeal cancers. It was the most common head and neck cancer diagnosed, with oral cavity cancer being the second most common (n = 1171). Seventy-seven percent were p16 positive (1170/1527), of which 87% (1019/1170) were male. The median age was 61 years and 49% (568/1170) presented with Stage I disease. The ASR was 6.3/100,000, representing a 144% incidence increase since 1982 (2.6/100,000). Radiotherapy was utilised in 91% of p16+ cases with 2- and 5- year overall survival of 89% and 79%, respectively.

Conclusion: OPSCC is now the most common mucosal head and neck cancer diagnosed in Queensland, having surpassed oral cavity cancer. The majority are HPV-associated (p16+), presenting with early-stage disease with a favourable prognosis.

Keywords: head and neck cancer; human papillomavirus; oropharyngeal; radiotherapy; squamous cell carcinoma.