HPV Prevalence in Oral Cavity Cancers in West Africa: Systematic Review and Meta-analysis

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Background: Human papillomavirus (HPV) infection has been established as a risk factor for oropharyngeal cancers, but its role in oral cavity cancers (OCC) remains controversial, particularly in West Africa where data are limited. Objective: To determine the prevalence of HPV infection in oral cavity cancers in West Africa through systematic review and meta-analysis. Methods: This systematic review followed PRISMA guidelines and was registered in PROSPERO (CRD42025644928). We searched MEDLINE, AJOL, ScienceDirect, Web of Science, EMBASE, Cochrane Library, and Scopus for studies published from 2000 to 2024. Eligible studies reported HPV prevalence in histologically confirmed oral cavity cancers in West African populations. Random-effects meta-analysis was performed using Freeman-Tukey transformation. Results: Nine studies from four West African countries (Senegal, Ghana, Nigeria, Burkina Faso) including 415 oral cavity cancer patients were analyzed. Overall pooled HPV prevalence was 6.59% (95% CI: 2.52-10.67%). Substantial geographical heterogeneity was observed (I² = 74.91%), with prevalences ranging from 0.75% in Senegal to 18.33% in Burkina Faso. Most studies used cross-sectional or retrospective designs analyzing preserved biopsy samples. HPV-16 was the most frequently detected high-risk genotype. Conclusion: HPV prevalence in oral cavity cancers is relatively low in West Africa compared to other global regions, with significant inter-country variation. These findings suggest that traditional risk factors may play a more prominent role than HPV in oral cavity carcinogenesis in this region. Standardized multicenter studies with larger sample sizes are needed to better characterize HPV distribution patterns.