@article{3087849,
    title = "HPV-associated lung cancers: An international pooled analysis",
    author = "Ragin, C. and Obikoya-Malomo, M. and Kim, S. and Chen, Z. and Flores-Obando, R. and Gibbs, D. and Koriyama, C. and Aguayo, F. and Koshiol, J. and Caporaso, N.E. and Carpagnano, G.E. and Ciotti, M. and Dosaka-Akita, H. and Fukayama, M. and Goto, A. and Spandidos, D.A. and Gorgoulis, V. and Heideman, D.A.M. and van Boerdonk, R.A.A. and Hiroshima, K. and Iwakawa, R. and Kastrinakis, N.G. and Kinoshita, I. and Akiba, S. and Landi, M.T. and Liu, H. and Wang, J.-L. and Mehra, R. and Khuri, F.R. and Lim, W.-T. and Owonikoko, T.K. and Ramalingam, S. and Sarchianaki, E. and Syrjanen, K. and Tsao, M.-S. and Sykes, J. and Hee, S.W. and Yokota, J. and Zaravinos, A. and Taioli, E.",
    journal = "Journal of Carcinogenesis",
    year = "2014",
    volume = "35",
    number = "6",
    pages = "1267-1275",
    publisher = "Oxford University Press",
    issn = "1477-3163",
    doi = "10.1093/carcin/bgu038",
    keywords = "DNA, adenocarcinoma;  adult;  aged;  Article;  bibliographic database;  cancer patient;  cancer risk;  Caucasian;  comparative study;  cross-sectional study;  disease association;  DNA integration;  female;  human;  Human papillomavirus type 16;  Human papillomavirus type 18;  human tissue;  lung cancer;  lung parenchyma;  major clinical study;  male;  medical history;  nonhuman;  papillomavirus infection;  prevalence;  priority journal;  risk factor;  South and Central America;  squamous cell carcinoma;  virus detection;  Wart virus;  Alphapapillomavirus;  article;  genetics;  genotype;  lung tumor;  meta analysis;  middle aged;  papillomavirus infection;  very elderly;  virology;  virus DNA cell DNA interaction, Aged;  Aged, 80 and over;  Alphapapillomavirus;  Female;  Genotype;  Human papillomavirus 16;  Human papillomavirus 18;  Humans;  Lung Neoplasms;  Male;  Middle Aged;  Papillomavirus Infections;  Prevalence;  Virus Integration",
    abstract = "Human papillomavirus (HPV) is the etiologic risk factor for cervical cancer. Some studies have suggested an association with a subset of lung tumors, but the etiologic link has not been firmly established. We performed an international pooled analysis of crosssectional studies (27 datasets, n = 3249 patients) to evaluate HPV DNA prevalence in lung cancer and to investigate viral presence according to clinical and demographic characteristics. HPV16/18 were the most commonly detected, but with substantial variation in viral prevalence between geographic regions. The highest prevalence of HPV16/18 was observed in South and Central America, followed by Asia, North America and Europe (adjusted prevalence rates = 22, 5, 4 and 3%, respectively). Higher HPV16 prevalence was noted in each geographic region compared with HPV18, except in North America. HPV16/18-positive lung cancer was less likely observed among White race (adjusted odds ratio [OR] = 0.33, 95% confidence interval [CI] = 0.12-0.90), whereas no associations were observed with gender, smoking history, age, histology or stage. Comparisons between tumor and normal lung tissue show that HPV was more likely to be present in lung cancer rather than normal lung tissues (OR = 3.86, 95% CI = 2.87-5.19). Among a subset of patients with HPV16-positive tumors, integration was primarily among female patients (93%, 13/14), while the physical status in male cases (N = 14) was inconsistent. Our findings confirm that HPV DNA is present in a small fraction of lung tumors, with large geographic variations. Further comprehensive analysis is needed to assess whether this association reflects a causal relationship. © The Author 2014. Published by Oxford University Press. All rights reserved."
}