{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T12:48:25Z","timestamp":1792414105611,"version":"4.4.0"},"reference-count":0,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T00:00:00Z","timestamp":1792368000000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The incidence of human papillomavirus (HPV)-driven oropharyngeal cancer (OPC) is increasing in several Western countries, but this trend is less well understood in other geographical regions and for other head and neck cancers (HNC). The BROADEN (absolute BuRden Of HPV relAteD hEad and Neck) study assessed HPV-attributable fractions (HPV-AFs) of HNC including OPC in France, Germany, Italy, Portugal, Spain, China, and Japan over a 10-year period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective study included patients diagnosed with HNC (oropharynx, oral cavity, nasopharynx, hypopharynx, and larynx cancer) in two time periods, 2008\u20132009 and 2018\u20132019. Formalin-fixed tissue samples were centrally tested for HPV-DNA, HPV-E6*I mRNA, and p16INK4a immunohistochemistry. HPV attributability required positive results in two of the three tests for OPC, and both HPV-DNA and HPV-E6*I mRNA positivity for other HNC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 6043 patients from 88 hospitals, the HPV-AF in OPC shown an increasing trend across all countries, with an HPV-AF ranging between 0% in Portugal and 44.2% in Japan in 2008-2009, and 20.0% and 51.7%, respectively, in 2018-2019. The increasing trend reached the statistical significance at 0.05 in all countries except China and Japan. Japan had the highest HPV-AF in 2008-2009. Other HNC showed lower HPV-AF (\u22645%) with no time trends.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>BROADEN is the first and largest study to date to investigate HPV causality and its time trends across five HNCs in seven countries. These results support the understanding of time trends and geographic variation in HPV-AF and are essential for global HNC prevention and treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag375","type":"journal-article","created":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T12:33:28Z","timestamp":1792413208000},"source":"Crossref","is-referenced-by-count":0,"title":["Time trends of human papillomavirus-attributable head and neck cancers: the BROADEN study"],"prefix":"10.1093","author":[{"given":"Tim","family":"Waterboer","sequence":"first","affiliation":[{"name":"German Cancer Research Center (DKFZ) Division of Infections and Cancer Epidemiology, , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fanghui","family":"Zhao","sequence":"additional","affiliation":[{"name":"National Cancer Center\/National Clinical Research Center for Cancer\/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College Department of Epidemiology, , Beijing,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Giuliano","sequence":"additional","affiliation":[{"name":"Moffitt Cancer Center Center for Infection Research in Cancer, , Tampa, FL,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miquel \u00c0ngel","family":"Pav\u00f3n","sequence":"additional","affiliation":[{"name":"Catalan Institute of Oncology (ICO)-Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de Llobregat Cancer Epidemiology Research Programme, ,","place":["Spain"]},{"name":"Instituto de Salud Carlos III Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), , Madrid,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"YouLin","family":"Qiao","sequence":"additional","affiliation":[{"name":"Chinese Academy of Medical Sciences and Peking Union Medical College School of Population Medicine and Public Health, , Beijing,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ha\u00eftham","family":"Mirghani","sequence":"additional","affiliation":[{"name":"Georges Pompidou Hospital AP-HP Department of Otolaryngology - Head and Neck Surgery, , Paris,","place":["France"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hisham","family":"Mehanna","sequence":"additional","affiliation":[{"name":"University of Birmingham Institute of Head and Neck Studies and Education (InHANSE), Institute of Cancer and Genomics Sciences, , Birmingham,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ken-Ichi","family":"Nibu","sequence":"additional","affiliation":[{"name":"Kobe University, Graduate School of Medicine Department of Otolaryngology-Head and Neck Surgery, , Kobe, Hyogo,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nobuhiko","family":"Oridate","sequence":"additional","affiliation":[{"name":"Yokohama City University Graduate School of Medicine Department of Biology and Function in Head and Neck, , Yokohama,","place":["Japan"]},{"name":"Yokohama City University, School of Medicine Department of Otorhinolaryngology - Head and Neck Surgery, , Yokohama,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shaokai","family":"Zhang","sequence":"additional","affiliation":[{"name":"Henan International Joint Laboratory of Cancer Prevention Department of Cancer Epidemiology, Affiliated Cancer Hospital of Zhengzhou University\/Henan Cancer Hospital, Henan Engineering Research Center of Cancer Prevention and Control, , Zhengzhou,","place":["China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniela","family":"H\u00f6fler","sequence":"additional","affiliation":[{"name":"German Cancer Research Center (DKFZ) Division of Infections and Cancer Epidemiology, , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lea","family":"Schroeder","sequence":"additional","affiliation":[{"name":"German Cancer Research Center (DKFZ) Division of Infections and Cancer Epidemiology, , Heidelberg,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gema","family":"Carretero","sequence":"additional","affiliation":[{"name":"Catalan Institute of Oncology , Girona,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omar","family":"Clavero","sequence":"additional","affiliation":[{"name":"Catalan Institute of Oncology (ICO)-Bellvitge Biomedical Research Institute (IDIBELL), L\u2019Hospitalet de 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