The Prevalence of Human Papillomavirus Associated Oropharyngeal and Oral Squamous Cell Carcinoma in Asian Countries: A Systematic Review and Large-scale Meta-analysis

Yy Jean Tan; Ken Wong Siong Hou; Galvin Sim Siang Lin; Jasmine Lim Suk Wun; Wan Nor Amira Wan Ahmad Abdul Nasir; Wei Linn Lynn Ko

doi:10.2478/amma-2023-0005

Yy Jean Tan Oral and Maxillofacial Surgery Department, Dental Specialist Clinic, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, 93586, Kuching, Sarawak, Malaysia
Ken Wong Siong Hou Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Universiti Kebangsaan Malaysia, 50300, Kuala Lumpur, Malaysia
Galvin Sim Siang Lin Department of Dental Materials, Faculty of Dentistry, Asian Institute of Medicine, Science and Technology (AIMST) University, 08100, Bedong, Kedah, Malaysia
Jasmine Lim Suk Wun Batu Kawa Dental Clinic, Ministry of Health Malaysia, 93250, Kuching, Sarawak, Malaysia.
Wan Nor Amira Wan Ahmad Abdul Nasir Oral and Maxillofacial Surgery Department, Dental Specialist Clinic, Sarawak General Hospital, Jalan Tun Ahmad Zaidi Adruce, 93586, Kuching, Sarawak, Malaysia.
Wei Linn Lynn Ko Department of Paediatric Dentistry & Orthodontics, Faculty of Dentistry, Universiti Malaya, 50603, Kuala Lumpur, Malaysia

DOI: https://doi.org/10.2478/amma-2023-0005

Keywords: Asia, Epidemiology, Mouth neoplasm, HPV, Polymerase chain reaction

Abstract

Human Papillomavirus (HPV) associated oropharyngeal and oral squamous cell carcinoma (OPSCC and OSCC) is escalating over the years. Hence, the present review aims to determine the prevalence of HPV-OSCC and HPV-OPSCC in Asian countries over the last decades. An electronic search was conducted using nine online databases to identify English-language articles on the prevalence of HPV-OPSCC and HPV-OSCC in Asian countries between January 2011 to June 2022. The risk of bias was assessed using the JBI critical appraisal checklist and the level of evidence was determined based on the OCEBM guideline. Single-arm meta-analysis was used to estimate the weighted mean prevalence of HPV-OPSCC and HPV-OSCC among patients in Asian. Subgroup analysis meta-regression and Egger’s tests were also conducted. 59 eligible studies were included with a higher prevalence of HPV-OPSCC (32.6%-37.4%) as compared to HPV-OSCC (10.9%-23.5%). Subgroup analysis revealed that the weighted mean prevalence of HPV-OPSCC was significantly higher (P<0.001) among East Asians, while the weighted mean prevalence of HPV-OSCC was significantly higher (P<0.001) among South Asians. All studies showed low to moderate risk of bias with the level of evidence ranked between 2 and 3. The diagnostic tools utilised and geographical locations significantly affect the findings.