Background Human papillomavirus (HPV) has been shown to be involved in the carcinogenic mechanisms of non-genital malignancies such as head and neck cancers. Particular HPV types may preferentially progress from infection to cancer of head and neck. However, prospective data on the carcinogenesis process of head and neck cancer remain limited. We aimed to assess data on the relative carcinogenic potential of HPV that can inform head and neck cancer prevention through vaccination and screening.

Methods We systematically reviewed relevant literature in MEDLINE, Embase and Cochrane Library to identify studies published before April, 2018, which reported type-specific HPV prevalence at head and neck. We pooled type-specific HPV prevalence across the full spectrum of head and neck diagnoses, from normal cytology to head and neck cancer, stratifying anatomical site, gender, region and HIV status.

Results A total of 150 studies were included in our review, contributing 6985 cases of normal cytology, 1782 cases of head and neck lesions, and 13587 cases of head and neck cancer. In HIV-negative individuals, pooled HPV prevalence was 6.42% (95% CI: 4.13–9.18%) for normal cytology, 18.86% (95% CI: 10.84–28.49%) for head and neck lesions, and 28.86% (95% CI: 24.26–33.70%) for head and neck cancer. Pooled HPV 16 prevalence increased with diagnosis severity, from 2.14% (95% CI: 0.86–3.94%) in normal cytology to 20.47% (95% CI: 16.58–24.65%) in head and neck cancer in HIV negative individuals. HPV prevalence varied by diagnosis, subsite, region, but not by gender. Data for HIV-positive patients were too limited to analyze.

Conclusion In HIV negative individuals, HPV prevalence increased with diagnosis severity. And HPV 16 was the most carcinogenic HPV type in head and neck, with enrichment from normal cytology to head and neck cancer.

Disclosure No significant relationships.