High Prevalence of Human Papillomavirus in Colorectal Cancer in Hispanics: A Case-Control Study

Abstract

The role of Human Papillomavirus (HPV) in colorectal carcinogenesis remains elusive. Based on the high incidence of HPV-associated malignancies among Puerto Rican Hispanics, this study aimed to assess the prevalence of HPV infection and viral integration in colorectal tissues in order to evaluate its putative role in colorectal cancer (CRC). In this case-control study, the prevalence of HPV infection in CRC (cases n = 45) and normal colon mucosa from cancer-free subjects (controls n = 36) was assessed by a nested PCR strategy. HPV-16 genotyping was performed in HPV-positive tissues and the physical status of the HPV-16 genome was determined by E2 detection. HPV was detected in 19 of 45 (42.2%) CRC cases (mean age 61.1 ± 10.7 years, 24 males) and in 1 of 36 (2.8%) controls (mean age 60.9 ± 9.6 years, 24 males) with an OR = 25.58 (95% CI 3.21 to 203.49). HPV-16 was detected in 63.2% of the HPV-positive colorectal tumors; genome integration was observed in all HPV-16 positive cases. This is the first report showing the high prevalence of HPV infections in Caribbean Hispanic colorectal tumors. Despite evidence of HPV integration into the host genome, further mechanistic analysis examining HPV oncoprotein expression and the putative role of these oncoproteins in colorectal carcinogenesis is warranted.

Does human papillomavirus cause human colorectal cancer? Applying Bradford Hill criteria postulates

“…A single case–control study [ 19 ] has been carried out in Puerto Rico so far to relate HPV with CRC. In total, 45 CRC and 36 normal samples were analysed in this study using the PCR technique, and they observed 42% and 2.8% HPV detection positivity ratio in CRC and normal controls, respectively ( Table 1 ).…”

Human Papillomavirus Type 16 Integration Analysis by Real-time PCR Assay in Associated Cancers

“…Colorectal cancer is one of the challenging issues, and its association with HPV infection is under investigation [45] , [46] . In the study by Bernabe-Dones et al [45] of 12 colorectal cancer patients infected with HPV-16 , the E2 gene evaluation for genome status by nested PCR method found that the genome in all the specimens was in an integrated form. They conclude that the integration of HPV-16 genome into the host genome could be a proof of the probable role of HPV in colorectal carcinogenesis.…”

Role of viruses in gastrointestinal cancer

“…Afterward, to investigate whether E6 oncoprotein could reduce p21 and mdm2 expression through p53 inactivation in p53 wild type tissues, they performed real‐time RT‐PCR analysis; the findings demonstrated that the levels of p21 and Mdm2 mRNA expression in E6 positive/p53‐wild type samples were significantly lower than in their surrounding normal mucosae. Their results proposed a possible role for HPV‐16 in “a subset of colorectal cancer.” Bernabe‐Dones and coworkers in a case‐control study reported a high prevalence of HPV‐16 and genome integration in CRC tissues (Bernabe‐Dones et al, ). In that study, HPV was found in 19 of 45 (42.2%) CRC samples, by nested‐PCR.…”