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Human papillomavirus in oropharyngeal cancer in Canada: analysis of 5 comprehensive cancer centres using multiple imputation.

Abstract The incidence of oropharyngeal cancer has risen over the past 2 decades. This rise has been attributed to human papillomavirus (HPV), but information on temporal trends in incidence of HPV-associated cancers across Canada is limited.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title cmaj : canadian medical association journal = journal de l'association medicale canadienne
Publication Year Start




PMID- 28808115
OWN - NLM
STAT- MEDLINE
DA  - 20170815
DCOM- 20170821
LR  - 20170824
IS  - 1488-2329 (Electronic)
IS  - 0820-3946 (Linking)
VI  - 189
IP  - 32
DP  - 2017 Aug 14
TI  - Human papillomavirus in oropharyngeal cancer in Canada: analysis of 5
      comprehensive cancer centres using multiple imputation.
PG  - E1030-E1040
LID - 10.1503/cmaj.161379 [doi]
AB  - BACKGROUND: The incidence of oropharyngeal cancer has risen over the past 2
      decades. This rise has been attributed to human papillomavirus (HPV), but
      information on temporal trends in incidence of HPV-associated cancers across
      Canada is limited. METHODS: We collected social, clinical and demographic
      characteristics and p16 protein status (p16-positive or p16-negative, using this 
      immunohistochemistry variable as a surrogate marker of HPV status) for 3643
      patients with oropharyngeal cancer diagnosed between 2000 and 2012 at
      comprehensive cancer centres in British Columbia (6 centres), Edmonton, Calgary, 
      Toronto and Halifax. We used receiver operating characteristic curves and
      multiple imputation to estimate the p16 status for missing values. We chose a
      best-imputation probability cut point on the basis of accuracy in samples with
      known p16 status and through an independent relation between p16 status and
      overall survival. We used logistic and Cox proportional hazard regression.
      RESULTS: We found no temporal changes in p16-positive status initially, but there
      was significant selection bias, with p16 testing significantly more likely to be 
      performed in males, lifetime never-smokers, patients with tonsillar or
      base-of-tongue tumours and those with nodal involvement (p < 0.05 for each
      variable). We used the following variables associated with p16-positive status
      for multiple imputation: male sex, tonsillar or base-of-tongue tumours, smaller
      tumours, nodal involvement, less smoking and lower alcohol consumption (p < 0.05 
      for each variable). Using sensitivity analyses, we showed that different
      imputation probability cut points for p16-positive status each identified a rise 
      from 2000 to 2012, with the best-probability cut point identifying an increase
      from 47.3% in 2000 to 73.7% in 2012 (p < 0.001). INTERPRETATION: Across multiple 
      centres in Canada, there was a steady rise in the proportion of oropharyngeal
      cancers attributable to HPV from 2000 to 2012.
CI  - (c) 2017 Canadian Medical Association or its licensors.
FAU - Habbous, Steven
AU  - Habbous S
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC [email protected] [email protected]
FAU - Chu, Karen P
AU  - Chu KP
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Lau, Harold
AU  - Lau H
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Schorr, Melissa
AU  - Schorr M
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Belayneh, Mathieos
AU  - Belayneh M
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Ha, Michael N
AU  - Ha MN
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Murray, Scott
AU  - Murray S
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - O'Sullivan, Brian
AU  - O'Sullivan B
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Huang, Shao Hui
AU  - Huang SH
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Snow, Stephanie
AU  - Snow S
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Parliament, Matthew
AU  - Parliament M
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Hao, Desiree
AU  - Hao D
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Cheung, Winson Y
AU  - Cheung WY
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Xu, Wei
AU  - Xu W
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC.
FAU - Liu, Geoffrey
AU  - Liu G
AD  - Ontario Cancer Institute (Habbous, O'Sullivan, Huang, Liu) and Department of
      Biostatistics (Xu), Princess Margaret Cancer Centre, Toronto, Ont.; Radiation
      Oncology (Chu, Belayneh, Parliament), Cross Cancer Institute, Edmonton, Alta.;
      Department of Oncology (Lau, Hao), University of Calgary, Alberta Health
      Services, Calgary, Alta.; Department of Oncology (Schorr, Hao), Division of
      Medical Oncology, Tom Baker Cancer Centre, Calgary, Alta.; Division of Medical
      Oncology (Ha, Murray, Snow), Nova Scotia Cancer Centre, Dalhousie University,
      Halifax, NS; Department of Radiation Oncology (O'Sullivan, Huang), Department of 
      Medicine (Liu) and Department of Epidemiology, Dalla Lana School of Public Health
      (Liu), University of Toronto, Toronto, Ont.; Medical Oncology (Cheung), BC Cancer
      Agency, Vancouver, BC [email protected] [email protected]
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PL  - Canada
TA  - CMAJ
JT  - CMAJ : Canadian Medical Association journal = journal de l'Association medicale
      canadienne
JID - 9711805
RN  - 0 (Biomarkers, Tumor)
RN  - 0 (Cyclin-Dependent Kinase Inhibitor p16)
RN  - 0 (P16 protein, human)
SB  - AIM
SB  - IM
MH  - Aged
MH  - Biomarkers, Tumor/analysis
MH  - Canada/epidemiology
MH  - Carcinoma, Squamous Cell/*epidemiology/virology
MH  - Cyclin-Dependent Kinase Inhibitor p16/*genetics
MH  - Databases, Factual
MH  - Female
MH  - Human papillomavirus 16
MH  - Humans
MH  - Immunohistochemistry
MH  - Incidence
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Oropharyngeal Neoplasms/*epidemiology/virology
MH  - Papillomavirus Infections/diagnosis/*epidemiology
MH  - Prognosis
MH  - Prospective Studies
MH  - ROC Curve
MH  - Sex Factors
MH  - Survival Analysis
PMC - PMC5555753
COI - Competing interests: None declared.
EDAT- 2017/08/16 06:00
MHDA- 2017/08/22 06:00
CRDT- 2017/08/16 06:00
PHST- 2017/03/09 [accepted]
AID - 189/32/E1030 [pii]
AID - 10.1503/cmaj.161379 [doi]
PST - ppublish
SO  - CMAJ. 2017 Aug 14;189(32):E1030-E1040. doi: 10.1503/cmaj.161379.