{"doi":"10.1101/2020.10.26.20213231","title":"Understanding the impact of high-risk human papillomavirus on oropharyngeal squamous cell carcinomas in Taiwan: A retrospective cohort study","abstract":"Abstract Background and Objectives Human papillomavirus (HPV)-driven oropharyngeal squamous cell carcinoma (OPSCC) is increasing globally. In Taiwan, HPV-positive OPSCC is obscured by tobacco, alcohol, and betel quid use. We investigated the role of high-risk HPV (hrHPV) in a large retrospective Taiwan OPSCC cohort. Methods and Results The cohort of 541 OPSCCs treated at Chang Gung Memorial Hospital from 1998-2016 consisted of 507 men (94%) and 34 women (6%). Most used tobacco (81%), alcohol (51%), and betel quid (65%). Formalin-fixed, paraffin-embedded tissue was used for p16 staining (a surrogate marker for HPV) and testing for HPV DNA presence and type by Multiplex HPV PCR-MassArray. HPV DNA and/or p16 staining (HPV-positive) was found in 28.4% (150/528) tumors. p16 and HPV DNA were strongly correlated ( F < 0.0001). HPV16 was present in 82.8%, and HPV58 in 7.5% of HPV-positive tumors. HPV was associated with higher age (55.5 vs. 52.7 years, p = 0.004), lower T-stage ( p = 0.008) better overall survival (OS) (hazard ratio [HR] 0.58 [95% CI 0.42-0.81], p = 0.001), and disease-free survival (DFS) (HR 0.54 [95% CI 0.40-0.73], p < 0.0001). Alcohol was strongly associated with recurrence and death (OS: HR 2.06 [95% CI 1.54-2.74], p < 0.0001; DFS: HR 1.72 [95% CI 1.33-2.24], p < 0.0001). OS and DFS in HPV-positive cases decreased for alcohol users ( p < 0.0001). Obscured by the strong alcohol effect, predictive associations were not found for tobacco or betel quid. Conclusions As with HPV-positive OPSCC globally, HPV is an increasingly important etiological factor in Taiwanese OPSCC. HPV-positive OPSCC has considerable survival benefit, but that is reduced by alcohol, tobacco, and betel quid use. hrHPV is a cancer risk factor in males and females. Vaccinating both sexes with a multivalent vaccine including HPV58, combined with alcohol and tobacco cessation policies will be effective cancer-prevention public health strategies in Taiwan.","journal":"medRxiv","year":2020,"id":122336,"datarank":0.26876392038420827,"base_score":1.791759469228055,"endowment":1.791759469228055,"self_citation_contribution":0.26876392038420827,"citation_network_contribution":0.0,"self_endowment_contribution":0.26876392038420827,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":5,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.5707,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":563323,"name":"Kai‐Ping Chang","orcid":"0000-0003-1777-9578","position":1,"is_corresponding":false},{"id":453229,"name":"Emily L. Bellile","orcid":"0000-0003-4350-4658","position":2,"is_corresponding":false},{"id":563324,"name":"Chun‐I Wang","orcid":"0000-0001-8332-0162","position":3,"is_corresponding":false},{"id":563325,"name":"Wei‐Chen Yen","orcid":"0000-0003-1029-8165","position":4,"is_corresponding":false},{"id":498594,"name":"Christine M. Goudsmit","orcid":null,"position":5,"is_corresponding":false},{"id":563326,"name":"Hannah L. Briggs","orcid":"0000-0003-0686-4523","position":6,"is_corresponding":false},{"id":563327,"name":"Trey B. Thomas","orcid":"0000-0002-5730-5417","position":7,"is_corresponding":false},{"id":564038,"name":"Lila Peters","orcid":null,"position":8,"is_corresponding":false},{"id":563328,"name":"Macy A. Afsari","orcid":"0000-0003-3784-3848","position":9,"is_corresponding":false},{"id":497928,"name":"Lisa Pinatti","orcid":"0000-0002-4864-5698","position":10,"is_corresponding":false},{"id":563329,"name":"Anna Morris","orcid":"0000-0002-8691-9653","position":11,"is_corresponding":false},{"id":563330,"name":"Nadine Jawad","orcid":"0000-0003-0325-5319","position":12,"is_corresponding":false},{"id":13324,"name":"Thomas E. Carey","orcid":"0000-0002-5202-7518","position":13,"is_corresponding":false},{"id":497931,"name":"Heather M. Walline","orcid":"0000-0003-3790-5738","position":14,"is_corresponding":false},{"id":421906,"name":"Guadalupe Lorenzatti Hiles","orcid":"0000-0002-8423-3279","position":0,"is_corresponding":true}],"reference_count":95,"raw_metadata":{"citation_network_status":"fetched"},"created_at":"2026-07-18T23:14:51.076430Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}