Molecular epidemiology of Human Papillomavirus in head and neck cancer patients, Sri Lanka; Application of non-invasive, cytology-based molecular diagnosis in a developing country

Aims: Head and neck carcinomas (HNC) have multifactorial aetiology including high-risk Human Papillomaviruses (HR-HPV). This study describes the molecular epidemiology of HR-HPV in OC/OPC patients and associated factors of HPV infection in OC/OPC patients, Sri Lanka.Materials and Methods: Lesion swabs of the 127 OC/OPC patients were collected in to liquid medium while, oral and oropharyngeal swabs were collected from 127 non-cancer population. Samples were tested with multiplex HR-HPV genotyping PCR assay. Data were analysed with SPSS.Results: HR-HPV was detected in 15% of cancer and 3% in non-cancer cohorts. HR-HPV type 16,39, 52,58 and 59 were contributed for 58%,5%,26%,10%,10% of total HR-HPV positivity in cancer patients and type 52 and 59 with 75% and 25% of positivity in non-cancer cohort respectively. Low education level, poor dental hygiene, smoking, betel chewing, large tumour size, presence of lymph nodes, primary tumour without recurrence and OPC type demonstrated a significant association with HR-HPV positivity in cancer group (p ≤ 0.05).Conclusion: Multiple HR-HPV types were detected significantly in the HNC study population in addition to clinical, sociodemographic and hygienic factors emphasizing the multifactorial aetiology. Non-invasive, cytology-based PCR in screening and diagnosis of HR-HPV and HPV vaccination covering all prevalent types are important tools in HNC cancer diagnosis and management.