Survey on human papillomavirus/p16 screening use in oropharyngeal carcinoma patients in the United States

Abstract

BACKGROUND:Patients with human papillomavirus (HPV)-positive oropharyngeal carcinoma (OC) have better prognosis than patients with HPV-negative OC. The objective of the current study was to assess how different practices across the United States treat patients with OC with respect to screening for HPV DNA or p16. METHODS: Five hundred forty-two randomly selected radiation oncologists were sent an 11-question survey by email regarding the use of HPV/p16 screening in OC. The questionnaire addressed demographics of the practice, intensity-modulated radiotherapy (IMRT) use, screening practices for HPV DNA or p16, which year this began, the use of HPV or p16 data to direct patient care, and future plans for its use if it had not already been instituted. RESULTS: One hundred ninety-two responses (39.6%) were received. Thirty-five percent of respondents (67 of 188) reported screening for HPV DNA routinely, whereas 4.8% of respondents (9 of 188) reported screening for p16. Of the physicians who did not use screening techniques, 37.2% (44 of 118 respondents) reported future plans to institute these screening techniques, 20% (9 of 45 respondents) stated plans to institute these techniques in the next 6 months, 55.5% (25 of 45 respondents) stated plans to institute these techniques within 6 months to 1 year, and 22.2% (10 of 45 respondents) stated plans to institute these techniques within 1 to 2 years. Academic physicians were more likely to use screening techniques (62.7%; P < .001) compared with private practitioners (31.4%). Only 12.4% of respondents reported using HPV or p16 data to direct care. CONCLUSIONS: Approximately 40.4% of radiation oncology practices that responded to a survey in the United States screened for HPV DNA or p16 in OC, whereas only 12.4% used it to further direct care. This number appears to be growing rapidly. Clinical trials to further elucidate how HPV or p16 status should direct care in OC are warranted. Cancer 2010;116:514-9.

North-American survey on HPV-DNA and p16 testing for head and neck squamous cell carcinoma

“…Presently, more than two thirds of physicians in our survey systematically test for HPV-DNA or p16 in HNSCC specimens, with an additional 10% stating that they will incorporate such practices in their institutions in the near future. As shown in a similar study, where United-States radiation oncologists were surveyed in early 2009 [27], our study shows a 27.5% increase in HPV-DNA and/or p16 testing in OPSCCs. More specifically, when comparing the responses we received from the AHNS, a primarily American-member association, and Shoushtari et al's study results, the proportion of respondents systematically testing for HPV-DNA and/or p16 has increased by over 100% in three years.…”

“…The overall response rate of 15.2% is lower compared to other published survey studies with physicians (30-40%) [27,38]. This may be due to the timing of our survey, as associations were contacted during summer months.…”

“…Nevertheless, over half of all respondents in our survey who systematically test for HPV-DNA and/or p16 reported using the test results to direct their treatment approach, likely towards some form of de-intensification. The latter proportion represents close to a 500% increase, compared to the group of radiation oncologists surveyed in 2009 [27].…”

Les cancers des voies aérodigestives supérieures associés aux papillomavirus

“…L'hybridation in situ (HIS) permet la caractérisation de l'ADN HPV en relation avec la morphologie cellulaire et tissulaire des tumeurs (Figure 3). Une surexpression de p16 par la tumeur en immunohistochimie est un marqueur indirect d'une infection par HPV [19]. La protéine p16 est un inhibiteur des CDK4 et CDK6 (cyclin dependent kinases) qui inactivent pRb, et elle intervient dans la phase G1 du cycle cellulaire.…”

“…Cette évolu-tion clinique favorable serait vraisemblablement due à une chimiosensiblité ou une radiosensibilité meilleures que celles des CEVADS non induits par les virus [19][20][21]. Cependant, les patients fumeurs HPV+ ont un moins bon pronostic que les patients HPV+ non fumeurs [22,23].…”