Oropharyngeal Squamous Cell Carcinoma and Human Papillomavirus-Associated Cancers in Women: Epidemiologic Evaluation of Association

Objective: Human papillomavirus (HPV) is a well-established etiologic factor in oropharyngeal squamous cell carcinoma (OPSCC). The objective of this study was to evaluate the association between OPSCC and HPV-related cancerous lesions of the cervix. Methods: Demographic, survival, and pathologic data on all female patients diagnosed with OPSCC in Alberta between 1998 and 2008 were collected. A review of pathology reports in these patients was undertaken to identify HPV-related cancerous lesions of the cervix. Standardized incidence ratios (SIRs) of cervical cancer in oropharyngeal cancer patients were calculated using control data obtained from provincial cancer surveillance. Overall and disease-specific survival of patients with OPSCC only versus patients with OPSCC and cervical cancer was calculated using Kaplan-Meier and Cox regression models. Results: Our results show a significantly elevated overall incidence of cervical cancer in women with OPSCC in comparison to the control population (SIR 29.4, 95% CI 12.05-74.98). Patients with OPSCC and cervical cancer also had a significantly improved disease-specific survival in comparison to patients with no history of cervical cancer. Conclusions: Women with OPSCC have a significantly elevated risk of developing HPV-related genital cancers, which suggests frequent HPV coinfection of oropharyngeal and genital tissues in this patient population. Women with OPSCC with cervical cancer also have an improved disease-specific survival, as previously shown with HPV-associated OPSCC.