Detection of Human Papilloma Virus and Risk Factors among Patients with Head and Neck Squamous Cell Carcinoma Attending a Tertiary Referral Centre in South India

Document Type : Research Articles


1 Department of Otorhinolaryngology and Head and Neck Surgery, K.S.Hegde Medical Academy, NITTE University-575018 Mangalore, Karnataka, India.

2 Department of Microbiology, Research Co-ordinator NUCSReM, K.S.Hegde Medical Academy, Nitte University-575018, Mangalore, Karnataka, India.

3 Senior Research Fellow, BRNS Project, Nitte University-575018, Mangalore, Karnataka, India.

4 Department of Biochemistry, Centre of Excellence in Molecular Biology and Regenerative Medicine, JSS Medical College, JSS University, Mysore, Karnataka, India.

5 5Associate Dean for Global Health, Wake Forest University School of Medicine, Attending Physician, Brenner Children's Hospital Winston Salem, NC, India.


Background: Head and Neck Squamous Cell Carcinomas (HNSCC) is the sixth most common cancer globally. In
India, on an average 25-30% of all cancer cases affect the head and neck. The etiological factors associated with HNSCC
are tobacco, alcohol and environmental carcinogens. However there are few cases, where there are no obvious risk
factors involved. In western counties, there are many reports of human papilloma virus (HPV) association with HNSCC.
Hence, we conducted a study to determine the role of HPV infection and risk factors among patients with HNSCC.
Materials and Methods: A prospective, cross-sectional study was conducted in a tertiary referral centre from January
2014 to March 2016. 88 patients were enrolled in the study. Socio- demographic, behavioural data, site and subsite
involvement, histopathology, staging and treatment were documented. Polymerase chain reaction (PCR) was performed
to detect the presence of HPV DNA using consensus primers MY 09/11 and GP5+/GP6+ and further the samples were
subjected to PCR for detecting HPV type 16 and 18. Results: The study included 88 participants with HNSCC. 57
had oral and oropharyngeal squamous cell carcinoma, 11 with laryngeal malignancy and 20 involving hypopharynx.
Among the participants buccal mucosa (n=22) was the most common subsite involved, majority (50%) had moderately
differentiated squamous cell carcinoma and 53.4% presented in stage IV. 2 (2.6%) cases were positive for HPV consensus
and both were positive for HPV 16, one case each in larynx and hypopharynx. There was statistical significance in the
association between betel nut chewing, cigarette smoking and alcohol intake as risk factors in the carcinogenesis of
HNSCC. Conclusion: In our setting in South India, HPV does not play a major role in the carcinogenesis of HNSCC
but betel nut chewing, tobacco exposure and alcohol consumption remain major risk factors for HNSCC.


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