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ORIGINAL ARTICLE
Year : 2020  |  Volume : 3  |  Issue : 3  |  Page : 170-181

Human papillomavirus associated with head and neck cancer in the Middle East and North Africa: A systematic review and meta-analysis


1 Department of Infection and Immunity, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
2 Department of Sexually Transmitted Infections, National Public Health Laboratory, Saudi Center for Diseases Prevention and Control, Riyadh, Saudi Arabia
3 College of Medicine, Alfaisal University, Riyadh, Saudi Arabia

Correspondence Address:
Fatimah Saeed Alhamlan
MBC 03, P.O Box 3354, Riyadh 11211
Saudi Arabia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/JNSM.JNSM_70_19

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Background: Head and neck cancer (HNC) is associated with tobacco or heavy alcohol use and chronic human papillomavirus (HPV) infection. Aims and Objectives: In this systematic review and meta-analysis, we determined the HPV-associated HNC prevalence rates and potential factors affecting prevalence rates in the Middle East and North Africa (MENA) region. Materials and Methods: Between July and August 2019, we searched and collected 38 articles from PubMed and Medline databases related to head and neck squamous cell carcinoma and HPV in the MENA region. Of those articles, 25 met the inclusion criteria. Results: The overall pooled HPV prevalence rate of all HNC cases reported in the MENA region was 16% (confidence interval 95%, 12%–21%). HPV was found primarily in the salivary glands (20%) and tonsils (16%). The characteristics of patients associated with HPV-driven HNC were being male, having a benign tumor, and using tobacco. The genotypes most strongly associated with HNC in the MENA region were HPV-16 followed by HPV-18. The highest reported prevalence rates of HPV-associated HNC were in Turkey (48%) and Palestine-Israel (31%), whereas the lowest were in Yemen (2%) and Saudi Arabia (4%). HNC-associated HPV prevalence decreased over time in the MENA region, from 19% during 1998–2010 to 15% during 2011–2014 to 12% during 2015–2019. Conclusion: Although the current prevalence of HPV-associated HNC in this region is low relative to rates observed elsewhere, HNC is typically fatal, and a global rise in HPV-driven HNC indicates that additional studies should be conducted in the MENA region to address this risk and to develop HPV awareness, screening, and vaccination programs.


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