Incidence and survival of oropharyngeal carcinoma patients and the development of HPVtesting prevalence in North Rhine-Westphalia: A Cancer Registry analysis from 2008-2018

e18070 Background: Oropharyngeal cancer (OPC) is caused by tobacco and alcohol or by HPV infection, which is associated with a better overall survival. A growing incidence of OPC with a decrease in other risk factors suggests a rising proportion of HPV-associated oropharyngeal carcinomas. However, regional differences exist and require further analyses. Therefore we analysed the incidence and the survival of OPC-patients and the test-rate for HPV in the largest European cancer registry in North-Rhine Westphalia (NRW), Germany. Methods: All patients diagnosed with oropharyngeal cancer (ICD-10: C01; C02.4; C05.1; C05.2; C09.0-9; C10.0-9) during 2008-2018 were included in the study. We assumed a carcinoma to be HPV-associated if either p16-IHC-test and/or HPV-DNA-PCR test was positive. In this retrospective study we analysed pseudonymized individual pathology and incidence reports collected by the cancer registry to extract our data. Five-year survival was calculated with the Kaplan-Meier Estimator. Results: A total of 10.652 cases of oropharyngeal cancer were reported in the study period. Age standardized incidence rate was 4.1 (SE 0.041) and constant over time. The majority (M:71.9%;n = 7663/W:28.1%n = 2989) of all cases were men, which is comparable to the distribution for HPV-associated OPC (M:70,3%;n = 786/W:29,7%;n = 332). 1,866 (17.5%) of OPC were tested for HPV. (M:70,4%;1314/W29,6%;552) In 2008 the test rate was 2.3% (n = 20), which increased steadily to 49.3% (n = 490) in 2018. HPV detection rate was 59,9% (n = 1118) in tested cases, which remained stable during the observation period.(M:59,8%; W:60,1%) Five-year survival was better for HPV-associated OPC (0.656; SE 0.023) than for non-HPV-associated OPC (0.430; SE 0.026) and not-HPV-tested OPC (0.468; SE 0.006). Five-year survival was slightly worse for men with OPC (0.466; SE 0.007) than for women (0.531; SE 0.011). The mean age was 63.0 (n = 10,652; HPV+Ø = 62,5; HPV-Ø = 62,7). Conclusions: In line with existing data, HPV-associated OPC achieved a better prognosis in NRW. HPV test rate increased in OPC recently, however, about 50% were still not tested. With relatively constant fractions of HPV-positive OPC in the tested group over the timespan our data does not suggest a rise in the fraction of HPV-associated OPC, which is in contrast to published data. The retrospective analyses, variance in HPV testing as well as the lack of occupational or behavioural hazards captured in the registry limit the interpretation of our data.