The changing incidence of human papillomavirus-associated oropharyngeal cancer using multiple imputation from 2000 to 2010 at a Comprehensive Cancer Centre
| Autor: | Ehab Fadhel, Bayardo Perez-Ordonez, John Waldron, Luke Harland, Wei Xu, Anthony La Delfa, Karen P. Chu, Brian O'Sullivan, Angela Hui, Ilan Weinreb, Steven Habbous, David Goldstein, Shao Hui Huang, Xin Qiu, Fei-Fei Liu, Geoffrey Liu |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Oncology
Adult Male Cancer Research medicine.medical_specialty Canada Time Factors Adolescent Epidemiology Cohort Studies Immunoenzyme Techniques Young Adult Internal medicine medicine Humans Imputation (statistics) Human papillomavirus Papillomaviridae Cyclin-Dependent Kinase Inhibitor p16 Aged Neoplasm Staging business.industry Incidence Head and neck cancer Papillomavirus Infections Middle Aged medicine.disease Missing data Prognosis Head and neck squamous-cell carcinoma Surgery Cancer registry stomatognathic diseases Oropharyngeal Neoplasms nervous system Head and Neck Neoplasms Cohort Carcinoma Squamous Cell Female business Follow-Up Studies |
| Zdroj: | Cancer epidemiology. 37(6) |
| ISSN: | 1877-783X |
| Popis: | Human papillomavirus (HPV) is a risk and prognostic factor for oropharyngeal cancer (OPC). Determining whether the incidence of HPV-associated OPC is rising informs health policy.HPV status was ascribed using p16 immunohistochemistry in 683/1474 OPC patients identified from the Princess Margaret Hospital's Cancer Registry (from 2000 to 2010). Missing p16 data was estimated using multiple (n=100) imputation (MI) and validated using an independent OPC cohort (n=214). Non-OPC head and neck squamous cell carcinoma (HNSCC) (n=3262) were also used for time-trend comparison. Regression was used to compare HNSCC subsets and time-trends. The c-index was used to measure the predictive ability of MI.The incidence of OPC rose from 23.3% of all HNSCC in 2000 to 31.2% in 2010 (p=0.002). In the subset of OPC tested for p16, there was no change in p16 positivity over time (p=0.9). However, p16 testing became more frequent over time (p0.0001), but was nonetheless biased, favouring never-smokers [OR 1.87 (95% CI 1.29-2.70)] and tumors of the tonsil [OR 2.30 (1.52-3.47)] or base-of-tongue [OR 1.72 (1.10-2.70)]. These same factors were also associated with p16-positivity [ORs 3.22 (1.27-8.16), 7.26 (3.50-15.1), 5.83 (2.70-12.7), respectively]. Following MI and normalization, the proportion of OPC that was p16-associated rose from 39.8% in 2000 to 65.0% in 2010, p=0.002, fully explaining the rise in OPC in our patient population.The rise in HNSCC referrals seen from 2000 to 2010 at our institution was driven primarily by p16-associated OPC. MI was necessary to derive reliable conclusions when cases with missing data are considerable. |
| Databáze: | OpenAIRE |
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