The emerging risk of oropharyngeal and oral cavity cancer in HPV-related subsites in young people in Brazil
The emerging risk of oropharyngeal and oral cavity cancer in HPV-related subsites in young people in Brazil
复制标题
DOI：
10.1371/journal.pone.0232871
复制
发表时间：
2020-05-14
期刊：
影响因子：
3.7
通讯作者：
Toporcov, Tatiana Natasha
中科院分区：
文献类型：
--
作者：
Menezes, Fabricio dos Santos;Dias de Oliveira Latorre, Maria do Rosario;Toporcov, Tatiana Natasha
人乳头瘤病毒（HPV）是导致口咽、扁桃体和舌根癌发病率上升的原因（即，HPV相关子网站）。HPV引发了亚洲、欧洲、北美和大洋洲口咽和口腔癌（OPC/OCC）流行病学的变化。因此，HPV相关亚位点的癌症发病率正在增加，而其他HPV无关亚位点的癌症发病率正在下降。在南美洲，虽然HPV阳性肿瘤的发病率逐渐增加，但OPC/OCC患者中HPV的患病率很低。为了阐明这一发病趋势的巨大变化是否也发生在这一人群中，我们估计了HPV对巴西圣保罗市OPC/OCC发病趋势的负担。在这项基于人群的研究中，我们根据HPV相关和HPV无关的亚位点对OPC/OCC进行分类。我们使用泊松回归来评估按性别和年龄组分层的年龄标准化发病率（ASR），并检查年龄-时期-队列效应。在HPV相关（n = 5，898; 38.3%）和HPV无关（n = 9，493; 61.7%）子位点中诊断出15，391例OPC/OCC。总体而言，除了年轻男性和女性的HPV相关OPC/OCC每年分别增加3.8%和8.6%外，大多数子位点的ASR在所有年龄组和性别中均下降。在出生队列效应分析中，我们发现在最近的出生队列中，两种性别的HPV相关OPC/OCC的风险都在增加;然而，这种风险在HPV无关的子位点中急剧下降。我们的数据表明，年轻人中出现HPV相关OPC/OCC的风险，这支持该群体的预防性HPV疫苗接种。
Human papillomavirus (HPV) is responsible for the rise in the incidence of cancer in the oropharynx, tonsils, and base of the tongue (i.e., HPV-related subsites). HPV triggered the changes in the epidemiology of oropharyngeal and oral cavity cancer (OPC/OCC) in Asia, Europe, North America, and Oceania. Hence, the incidence of cancer in HPV-related subsites is augmenting, while that in other HPV-unrelated subsites is decreasing. In South America, although the incidence of HPV-positive tumors has gradually increased, there is an atypically low prevalence of HPV in people with OPC/OCC. To clarify whether this dramatic shift in incidence trends also occurred in this population, we estimated the burden of HPV on the incidence trends of OPCs/OCCs in Sao Paulo city in Brazil. In this population-based study, we categorized OPCs/OCCs by HPV-related and HPV-unrelated subsites. We used Poisson regression to assess the age-standardized incidence rates (ASRs) stratified by sex and age groups, as well as to examine the age-period-cohort effects. There were 15,391 cases of OPCs/OCCs diagnosed in HPV-related (n = 5,898; 38.3%) and HPV-unrelated (n = 9,493; 61.7%) subsites. Overall, the ASRs decreased for most subsites, for both sexes and for all age groups, except for HPV-related OPC/OCC in young males and females, which increased by 3.8% and 8.6% per year, respectively. In the birth-cohort-effect analysis, we identified an increasing risk for HPV-related OPC/OCC in both sexes in recent birth cohorts; however, this risk was sharply decreased in HPV-unrelated subsites. Our data demonstrate an emerging risk for HPV-related OPC/OCC in young people, which supports prophylactic HPV vaccination in this group.