Time trends of human papillomavirus-attributable head and neck cancers: the BROADEN study

BACKGROUND: The incidence of human papillomavirus (HPV)-driven oropharyngeal cancer (OPC) is increasing in several Western countries, but this trend is less well understood in other geographical regions and for other head and neck cancers (HNC). The BROADEN (absolute BuRden Of HPV relAteD hEad and Neck) study assessed HPV-attributable fractions (HPV-AFs) of HNC including OPC in France, Germany, Italy, Portugal, Spain, China, and Japan over a 10-year period. METHODS: This retrospective study included patients diagnosed with HNC (oropharynx, oral cavity, nasopharynx, hypopharynx, and larynx cancer) in two time periods, 2008-2009 and 2018-2019. Formalin-fixed tissue samples were centrally tested for HPV-DNA, HPV-E6*I mRNA, and p16INK4a immunohistochemistry. HPV attributability required positive results in two of the three tests for OPC, and both HPV-DNA and HPV-E6*I mRNA positivity for other HNC. RESULTS: Among 6043 patients from 88 hospitals, the HPV-AF in OPC shown an increasing trend across all countries, with an HPV-AF ranging between 0% in Portugal and 44.2% in Japan in 2008-2009, and 20.0% and 51.7%, respectively, in 2018-2019. The increasing trend reached the statistical significance at 0.05 in all countries except China and Japan. Japan had the highest HPV-AF in 2008-2009. Other HNC showed lower HPV-AF (≤5%) with no time trends. CONCLUSION: BROADEN is the first and largest study to date to investigate HPV causality and its time trends across five HNCs in seven countries. These results support the understanding of time trends and geographic variation in HPV-AF and are essential for global HNC prevention and treatment.

Authors

Institutions

Publication Details

Journal
JNCI Journal of the National Cancer Institute
Published
2026-10-19
DOI
https://doi.org/10.1093/jnci/djag375
Primary Topic
Head and Neck Cancer Studies
Type
article
Field-Weighted Citation Impact
0.00
Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Time trends of human papillomavirus-attributable head and neck cancers: the BROADEN study

Hisham Mohamed Mehanna, Montserrat Roset, Daniela Höfler, Gema Carretero et al.
JNCI Journal of the National Cancer Institute
Head and Neck Cancer Studies
article

Time trends of human papillomavirus-attributable head and neck cancers: the BROADEN study

Hisham Mohamed Mehanna, Montserrat Roset, Daniela Höfler, Gema Carretero, Nobuhiko Oridate, Craig S. Roberts, Núria Lara, Jacque Spitzer, H. Mirghani, Ken‐ichi Nibu, Anna R. Giuliano, Tim Waterboer, Marisa A. Felsher, Marta Forés Maresma, Omar Clavero, 乔友林, Laia Alemany, Edith Morais, Lea Schroeder, Miquel Angel Pavón, Vivian Wang, Ya-Ting Chen, Fanghui Zhao, Shaokai Zhang
article en

Abstract

BACKGROUND: The incidence of human papillomavirus (HPV)-driven oropharyngeal cancer (OPC) is increasing in several Western countries, but this trend is less well understood in other geographical regions and for other head and neck cancers (HNC). The BROADEN (absolute BuRden Of HPV relAteD hEad and Neck) study assessed HPV-attributable fractions (HPV-AFs) of HNC including OPC in France, Germany, Italy, Portugal, Spain, China, and Japan over a 10-year period. METHODS: This retrospective study included patients diagnosed with HNC (oropharynx, oral cavity, nasopharynx, hypopharynx, and larynx cancer) in two time periods, 2008-2009 and 2018-2019. Formalin-fixed tissue samples were centrally tested for HPV-DNA, HPV-E6*I mRNA, and p16INK4a immunohistochemistry. HPV attributability required positive results in two of the three tests for OPC, and both HPV-DNA and HPV-E6*I mRNA positivity for other HNC. RESULTS: Among 6043 patients from 88 hospitals, the HPV-AF in OPC shown an increasing trend across all countries, with an HPV-AF ranging between 0% in Portugal and 44.2% in Japan in 2008-2009, and 20.0% and 51.7%, respectively, in 2018-2019. The increasing trend reached the statistical significance at 0.05 in all countries except China and Japan. Japan had the highest HPV-AF in 2008-2009. Other HNC showed lower HPV-AF (≤5%) with no time trends. CONCLUSION: BROADEN is the first and largest study to date to investigate HPV causality and its time trends across five HNCs in seven countries. These results support the understanding of time trends and geographic variation in HPV-AF and are essential for global HNC prevention and treatment.

JNCI Journal of the National Cancer Institute
Merck & Co., Inc., Rahway, NJ, USA (United States) (US), German Cancer Research Center (DE), Chinese Academy of Medical Sciences & Peking Union Medical College (CN), Heidelberg University (DE), Catalan Institute for Water Research (ES), Peking Union Medical College Hospital (CN), Instituto de Salud Carlos III (ES), Bellvitge University Hospital (ES), IQVIA (United Kingdom) (GB), Moffitt Cancer Center (US), Institut d'Investigació Biomédica de Bellvitge (ES), National Cancer Center (US), Assistance Publique – Hôpitaux de Paris (FR), Hôpital Européen Georges-Pompidou (FR), Institut Català d'Oncologia (ES), Henan Cancer Hospital (CN), Centre Pompidou (FR), IQ Solutions (US), Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (ES), Kobe University (JP), Yokohama City University (JP)
Openalex Percentile: Top 9%
Head and Neck Cancer Studies
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.