Systematic Review of HPV-Related Head and Neck Cancers in Latin American Countries

Abstract

Objectives:

Human papillomavirus (HPV)–related head and neck squamous cell carcinoma (HNSCC) is extensively studied in the developed world but relatively less studied in developing countries. The goal of this review is to determine the state of knowledge of HPV-related HNSCC in Latin American countries (LACs) and to highlight areas that would benefit from additional research.

Methods:

Databases searched included PubMed and Virtual health library (LILAC). All Latin American studies addressing HPV-related HNSCC of oral cavity, oropharynx, and larynx were selected. We did not restrict studies by type of study, sample size, or method of HPV detection; however, case reports were excluded. Each article was reviewed for incidence/prevalence of HPV-positive HNSCC, demographics, social history, and clinical outcomes.

Results:

Thirty-eight full-text articles were reviewed that identified HPV-positivity in 33%, HPV 16 being most prevalent. Twenty-three of 38 (60%) had a sample size <50, and a HPV-negative control group was described in only 8 out of 38 (21%) articles. Oral cavity rather than oropharynx was mostly studied, with “tongue” the most commonly involved site, raising concerns for misclassification of site between oral cavity and oropharynx. Sexual history, the most significant risk factor for HPV, was addressed in only 2 out of 38 articles. Prognosis/survival was addressed in 8 out of 38 articles, and only 2 articles described better survival outcomes in HPV-positive cases.

Conclusions:

Future research on HPV in LACs should emphasize consistent classification of tumor topography, larger sample sizes, and comparison with HPV-negative control groups. The role of sexual history/behavior and better prognosis of HPV-positive tumors are critical observations in the developing world that require further investigation in LACs.