Current status of human papillomavirus positivity in oropharyngeal squamous cell carcinoma in Europe: a systematic review

Background: The incidence of oropharyngeal squamous cell carcinoma (OPSCC) has been rising in the Western world in recent years. Human papillomavirus (HPV) infection is established as the main explanation. Aims/objectives: This study aims to review the most recently published studies on the repartition of HPV-positive OPSCC in Europe. Method and material: PubMed and Embase were systematically searched for articles addressing the distribution of HPV-positive and HPV-negative cases among OPSCC patients in Europe. Articles published in the period 2014-2018, with a study period including 2013 and the following years were included. The presence of HPV DNA and p16 overexpression, either solely or together, were accepted as indicators of HPV-positivity. Information on the anatomical sublocation of the tumour, definition of HPV-status, HPV type, HPV status, age, sex, TNM-stage, smoking habits and alcohol consumption were extracted. Results: Seven articles (n = 2075 patients, range: 22-926 patients per study) from seven European countries were included. The repartition of HPV-positivity ranged from 18% to 65%. The lowest occurrence of HPV-positivity was seen in Greece and the Netherlands, and the highest in Sweden and Denmark. Conclusion/significance: The highest share of HPV-positive patients with up to 65% was found in Nordic countries. The lowest share was found in Central and Southern European countries.