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Christina S. Chu and David G. Pfister

Human papillomavirus (HPV) is a double-stranded DNA virus of >100 subtypes. Through close mucosal contact, high-risk subtypes can facilitate the development of epithelial cancers and can influence tumor activity and disease prognosis. The good

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Kathleen N. Moore and Joan L. Walker

and pathologic study of koilocytotic atypia . Ann N Y Acad Sci 1956 ; 63 : 1245 – 1261 . 5 Clavel C Masure M Bory JP . Human papillomavirus testing in primary screening for the detection of high-grade cervical lesions: a study of 7932

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Philip E. Castle

guidelines for management of abnormal cervical cytology. The 1992 National Cancer Institute Workshop . JAMA 1994 ; 271 : 1866 – 1869 . 8. Walboomers JM Jacobs MV Manos MM . Human papillomavirus is a necessary cause of invasive cervical cancer

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Erich M. Sturgis and K. Kian Ang

exposure (smoking) but, during the same period, the emergence of a second unrelated etiologic exposure. Several lines of evidence have established the carcinogenic potential of human papillomavirus (HPV), and since the early 1990s HPV DNA has been

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Benjamin E. Greer, Wui-Jin Koh, Nadeem R. Abu-Rustum, Sachin M. Apte, Susana M. Campos, John Chan, Kathleen R. Cho, Larry Copeland, Marta Ann Crispens, Nefertiti DuPont, Patricia J. Eifel, David K. Gaffney, Warner K. Huh, Daniel S. Kapp, John R. Lurain III, Lainie Martin, Mark A. Morgan, Robert J. Morgan Jr., David Mutch, Steven W. Remmenga, R. Kevin Reynolds, William Small Jr., Nelson Teng, and Fidel A. Valea

most common cancer in women worldwide, 6 , 7 with 78% of cases occurring in developing countries, where cervical cancer is the second most frequent cause of cancer death in women. Persistent human papillomavirus (HPV) infection is regarded as the

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Himani Aggarwal, Li Li, Gebra Cuyun Carter, Kathy Fraeman, and Ariel Berger

Background: The incidence of oropharyngeal cancer (OPC) due to tobacco and alcohol, respectively, has been declining, while that linked to human papilloma virus (HPV) has been rising. Epidemiologic, biologic, and prognostic characteristics of OPC differ by HPV-status. This study compared overall survival (OS) among HPV-positive and -negative patients with OPC in a real-world setting. Methods: This retrospective observational study used electronic medical records data from the Geisinger Health System to select patients diagnosed with OPC between January 1, 2010 and September 30, 2015. Patients were designated as HPV-positive if the HPV or P16 test closest to the diagnosis date was positive. All other patients were deemed HPV-negative. Descriptive statistics and relevant statistical tests were used to compare baseline characteristics by HPV status; survival by HPV status was examined using Kaplan–Meier methods and multivariable Cox models. Results: In this study, 152 patients met all selection criteria; 110 (72.4%) were HPV-positive. HPV-positive patients were more likely to be men (89.1% vs 73.8%; P=.019) and to have lymph node involvement (88.2% vs 59.5%; P=.0008); they were less likely to have cerebrovascular disease (6.9% vs. 23.5%; P=.01), or distant metastases (1.8% vs 9.5%; P=.029) vs HPV-negative patients. Among HPV-positive patients, 75.5%, 12.7%, and 10.9% had squamous cell carcinoma NOS, basaloid squamous cell carcinoma, and squamous cell carcinoma large cell non-keratinizing, respectively; corresponding values for HPV-negative patients were 85.7%, 0.0%, and 2.4%, respectively (P=.0013). HPV-positive patients were nominally younger than HPV-negative patients (median: 58 vs 61 years; P=.085). Log-rank test showed OS of HPV-positive patients (median OS from treatment initiation: not reached) is higher than of HPV-negative patients (median OS: 3.7 years; P=.002). In multivariable analyses, HPV-negative status was associated with increased mortality risk (P=.0035); other significant risk factors included alcohol use, diabetes, and distant metastases. Conclusions: HPV-positive status was associated with a decreased risk of mortality among OPC patients in this study. Despite the small sample size and potential violation of assumption of proportional hazard rate, this study underscores the prognostic implication of HPV status in OPC, which may have important ramifications in optimizing treatment decisions among this patient population.

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Anna-Barbara Moscicki

Shiboski S . Risks for incident human papillomavirus infection and low-grade squamous intraepithelial lesion development in young females . JAMA 2001 ; 285 : 2995 – 3002 . 5. Winer RL Lee SK Hughes JP . Genital human papillomavirus infection

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Aysegul A. Sahin, Timothy D. Gilligan, and Jimmy J. Caudell

these histopathologic findings,” Dr. Gilligan stated. “We need better studies to answer these and other questions.” Head and Neck Cancers Staging Over the past 3 decades, human papillomavirus (HPV)–positive status has been recognized as a new etiologic

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Kristopher J. Kimball and Warner K. Huh

. Cervical Cancer Facts and Figures . Atlanta, GA : American Cancer Society ; 2005 : 1 – 61 . 2. Fleurence RL Dixon JM Milanova TF . Review of the economic and quality-of-life burden of cervical human papillomavirus disease . Am J Obstet

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David Adelstein, Maura L. Gillison, David G. Pfister, Sharon Spencer, Douglas Adkins, David M. Brizel, Barbara Burtness, Paul M. Busse, Jimmy J. Caudell, Anthony J. Cmelak, A. Dimitrios Colevas, David W. Eisele, Moon Fenton, Robert L. Foote, Jill Gilbert, Robert I. Haddad, Wesley L. Hicks Jr, Ying J. Hitchcock, Antonio Jimeno, Debra Leizman, William M. Lydiatt, Ellie Maghami, Loren K. Mell, Bharat B. Mittal, Harlan A. Pinto, John A. Ridge, James Rocco, Cristina P. Rodriguez, Jatin P. Shah, Randal S. Weber, Matthew Witek, Frank Worden, Sue S. Yom, Weining Zhen, Jennifer L. Burns, and Susan D. Darlow

increase in human papillomavirus (HPV)–associated oropharyngeal cancer, as well as the recent availability of immunotherapy agents for patients with recurrent or metastatic disease. HPV and H&N Cancer HPV infection is associated with an estimated 4