Epidemiological and Prognostic Profile of HPV-Positive Oropharyngeal Cancer in Brazil: a key for Additional Outputs in Carcinogenesis Understanding

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All articles of this category (opens in new window) Address for correspondence Kenia Cristina Correia Martins (keniaccorreia@gmail.com) Background: The epidemiology of oropharyngeal squamous cell carcinoma (OPSCC) has shifted globally, with an increasing incidence of HPV-related cases. Associated with a better prognosis, this tumor subtype is more common among younger and non-smoking individuals. However, the coexistence of HPV infection and smoking may impact the natural history of these tumors, suggesting additional mechanisms in carcinogenesis. Therefore, epidemiological analyses are important tools for improving the understanding of OPSCC . Objective: To evaluate the epidemiological and prognostic profile of HPV-positive OPSCC patients treated at a public referral center in Minas Gerais, Brazil . Methods: A retrospective, observational cohort study was conducted among patients diagnosed with non-metastatic OPSCC between January 2015 and December 2023. HPV status was assessed by p16 immunohistochemistry. Clinical data were obtained from electronic medical records. Comparisons were made with previously published international cohorts. The institutional ethics committee approved the study . Results: Among OPSCC patients (n=287), 50 (17.4%) were p16-positive. The median follow-up was 29.5 months. In the HPV-positive group, the median age at diagnosis was 59 years; 82% were male, and the most frequent primary site was the tonsil. At diagnosis, 62% were stage III. Regarding smoking status, 26% were never smokers, 44% were former smokers, and 30% were current smokers; 60% of current/former smokers had more than 10 pack-years. Compared to international data, HPV-positive patients are typically diagnosed at a median age of 54 years, and only 10–20% are active smokers at diagnosis. During follow-up, 11 patients (22%) experienced recurrence, and 23 (46%) died . Conclusion: Compared to international cohorts, HPV-positive OPSCC patients in this Brazilian public health cohort were older at diagnosis. They had a significantly higher prevalence of smoking, a factor associated with worse outcomes, even in HPV-related cancers, despite the underlying carcinogenic mechanisms being poorly understood. These findings highlight important regional differences that may influence prognosis and treatment decisions. Publication History Article published online: 26 June 2026 © 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/) Thieme Revinter Publicações Ltda. Rua Rego Freitas, 175, loja 1, República, São Paulo, SP, CEP 01220-010, Brazil Bibliographical Record Kenia Cristina Correia Martins, Paulo Guilherme de Oliveira Salles, Pedro Andrade Villar Pires, Paula Valente Silva, Rui Lafaiete Brasil Neto, Filipe Saliba Lança, Luma Barbosa Capanema, Breno Soares Aguiar, Gustavo Cancela Penna, Letícia Conceição Braga, Paulo Henrique Costa Diniz. Epidemiological and Prognostic Profile of HPV-Positive Oropharyngeal Cancer in Brazil: a key for Additional Outputs in Carcinogenesis Understanding. Brazilian Journal of Oncology 2026; 22. DOI: 10.1055/s-0046-1825316

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