Impact of human papillomavirus (HPV) infection on the development of oral squamous cell carcinoma (OSCC): A systematic review

Abstract

This systematic review aimed to identify, select and synthesize clinical studies reporting the prevalence of HPV infection among patients with OSCC, and to determine the odds ratio (OR) of HPV infection in a group of OSCC patients relative to non-OSCC controls through meta-analysis. The study incorporated primary clinical trials that assessed the impact of HPV infection on the development of OSCC. The search was conducted on August 31, 2023, using Bielefeld Academic Search Engine (BASE), as well as PubMed® and Scopus databases. The Newcastle–Ottawa Quality Assessment Scale was used to assess the risk of bias of the included studies. The collected data was then synthesized in the form of tables and a funnel plot. A total of 54 eligible studies were selected for the review, and 10 reports were included in the meta-analysis. Of the 10 papers, 7 reported extractable numerical data on HPV-16 and/or HPV-18 (1,035 patients). The limitations of the evidence included the following: inhomogeneity in terms of HPV type; small number of available controlled studies (not homogeneous in terms of virus type); small number of patients on whom controlled studies were conducted; and the risk of bias related to the selection of study and control groups (present in most studies qualified for the synthesis). In conclusion, HPV is detected by genetic testing in 0.0–74.5% of patients who develop OSCC. The weighted mean OR of detecting HPV-16 or HPV-18 in OSCC patients (OR=17.1; standard deviation (SD)=31.4) suggests a potential correlation between these infections and the incidence of OSCC.