EC Dental Science

Background: Various groups of researchers globally have evaluated the role of HPV (Human papilloma virus) in causing oro-pharyngeal squamous cell carcinoma (OPSCC) and reported its significant role in determining the pathogenesis, development and prognosis in oral cancers. Most of the published data has come from the western countries where the role of HPV is well established in causing OPSCC. However, there is a paucity of data on the role of HPV in causing OPSCC in the Indian perspective.

Aim and Objectives: To investigate the role of HPV in causing OPSCC in Indian Perspective and to further evaluate the utility of cervical cancer screening methods and prophylactic tools in the prevention of OPSCC.

Data: Randomized/Quasi-randomized controlled clinical trials.

Sources: Four electronic databases and grey literature up to July 2023.

Study Selection: Two reviewers independently selected the studies; they extracted the data and assessed the risk of biases using the Cochrane risk of bias tool 2.0. Only 40 studies fulfilled the inclusion criteria.

Participants and Interventions: Indian peer reviewed original studies published in the last 11 years considering patients between the age group 18 - 70 were included. The papers that included confirmatory Biopsy/histopathology reports positive for OPSCC were included. Individuals presented exclusively with OPSCC involving tobacco and non-tobacco consumers were included.

Limitations: No heterogeneity test was evident which may alter the result. Only English language papers were used that might have missed the papers in other languages. Analysis of the impacts of possible confounding factors, such as smoking and tobacco, genetics and heterogeneity of the studies that should be considered has been missed.

Conclusion: In a developing country like India tobacco still remains the primary cause of OSCC. The amount of population presenting non-tobacco causes in the causation of OSCC is very scant. Furthermore, heterogeneity in data was observed which was mainly attributed to a) social and cultural habits of the enrolled cases, b) discrepancies in the nature of samples procured and c) varying sensitivity of the assays employed for detection of HPV. Due to the inconsistency of data pertaining to HPV prevalence in OSCC in different regions of India, it remains inconclusive to draw any correlation between HPV and OPSCC in India. Within the constraints of the current research it can be said that the strategies used for screening and management of cervical cancers can’t be applied to the OPSCC carcinomas.

Future Directions: To establish a definitive role of HPV in the prognosis and treatment of OSCC in India, a robust effort is required in terms of the standard operating procedure to be followed for standardization of sample size, sample procuration and testing assays by the practicing oncologists in collaboration with maxillofacial surgeons and researchers in India.

Keywords: HPV (Human Papilloma Virus); Oro-Pharyngeal Squamous Cell Carcinoma (OPSCC); India; Asian Country; Oral Cancer; Non-tobacco Oral Squamous Cell Carcinoma

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