{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T11:25:52Z","timestamp":1786965952102,"version":"build-2736575974"},"reference-count":41,"publisher":"FapUNIFESP (SciELO)","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"am","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100002322","name":"Coordena\u00e7\u00e3o de Aperfei\u00e7oamento de Pessoal de N\u00edvel Superior \u2013 Brasil","doi-asserted-by":"crossref","award":["001"],"award-info":[{"award-number":["001"]}],"id":[{"id":"10.13039\/501100002322","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rev. bras. epidemiol."],"abstract":"<jats:p>ABSTRACT  Objectives: To evaluate the clinical-epidemiological profile of patients with oropharyngeal cancer (OPC) positive for human papillomavirus (HPV+) and negative for human papillomavirus (HPV\u2212), and to compare differences in the development of second primary tumors (SPT).  Methods: Retrospective cohort with patients diagnosed with OPC. Sociodemographic\/clinical data, p16-status, alcohol\/tobacco consumption were extracted. Absolute\/relative frequencies, odds ratios (OR), prevalence of HPV and SPT were calculated.  Results: Of 538 patients with OPC, 59.8% (n=322) were HPV+; 40.2% (n=216) HPV\u2212. The prevalence of SPTs was higher among HPV\u2212 (21.8%; n=47) than HPV+ (13.0%; n=42). Non-smokers were 4.5 times more likely to have HPV+ OPC (OR 4.58; confidence interval \u2014 CI 2.48\u20138.67), and non-drinkers were 2.06 times more likely (OR=2.06; CI 1.15\u20133.72). Nodal involvement was associated with a 2.77-fold higher likelihood of HPV+ (OR 2.77; CI 1.70\u20134.56); lymphoepithelial topographies with a 2.13-fold higher likelihood (OR 2.13; CI 1.37\u20133.31). SPTs occurred most in the skin (17.3%, n=9) and penis\/prostate (15.4%, n=8) in HPV+, whereas in HPV- in head and neck (36.2%, n=22) and respiratory tract (18.0%, n=11). The interval between OPC diagnosis and SPT diagnosis was shorter in the HPV+ (median: 40 months).  Conclusion: SPT pattern in OPC is not equal across HPV-groups. HPV- showed a higher prevalence of SPTs, more often involving the head and neck\/respiratory tract, which may reflect the cumulative effect of tobacco\/alcohol exposure. In HPV+, the lower SPT prevalence and different tumor distribution may indicate a more limited field cancerization effect. The shorter time to SPT diagnosis in HPV+ suggests that surveillance strategies may need to consider distinct risk profiles according to HPV-status.<\/jats:p>","DOI":"10.1590\/1980-549720260046","type":"journal-article","created":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:47:29Z","timestamp":1786963649000},"source":"Crossref","is-referenced-by-count":0,"title":["Clinical profile and pattern of second primary tumors in HPV-positive and HPV-negative oropharyngeal cancer"],"prefix":"10.1590","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3914-3108","authenticated-orcid":false,"given":"Matheus de","family":"Abreu","sequence":"first","affiliation":[{"name":"A.C. Camargo Cancer Center,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7523-7980","authenticated-orcid":false,"given":"Dandara Menezes de Araujo","family":"Oliveira","sequence":"additional","affiliation":[{"name":"A.C. Camargo Cancer Center,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8208-6092","authenticated-orcid":false,"given":"Janaina Naiara","family":"Germano","sequence":"additional","affiliation":[{"name":"A.C. Camargo Cancer Center,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0481-156X","authenticated-orcid":false,"given":"Luiz Paulo","family":"Kowalski","sequence":"additional","affiliation":[{"name":"A.C. Camargo Cancer Center,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8172-2483","authenticated-orcid":false,"given":"Maria Paula","family":"Curado","sequence":"additional","affiliation":[{"name":"A.C. Camargo Cancer Center,  Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"530","published-online":{"date-parts":[[2026]]},"reference":[{"issue":"3","key":"ref1","first-page":"229","article-title":"Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"74","author":"Bray F","year":"2024","journal-title":"CA Cancer J Clin"},{"issue":"2","key":"ref2","doi-asserted-by":"crossref","first-page":"e180","DOI":"10.1016\/S2214-109X(19)30488-7","article-title":"Global burden of cancer attributable to infections in 2018: a worldwide incidence analysis","volume":"8","author":"de Martel C","year":"2020","journal-title":"Lancet Glob Health"},{"issue":"2","key":"ref3","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1177\/0022034519894963","article-title":"Incidence trends of lip, oral cavity, and pharyngeal cancers: global burden of disease 1990\u20132017","volume":"99","author":"Du M","year":"2020","journal-title":"J Dent Res"},{"issue":"9","key":"ref4","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1038\/sj.bdj.2018.922","article-title":"The changing epidemiology of oral cancer: definitions, trends, and risk factors","volume":"225","author":"Conway DI","year":"2018","journal-title":"Br Dent J"},{"issue":"1","key":"ref5","first-page":"51","article-title":"The global incidence of lip, oral cavity, and pharyngeal cancers by subsite in 2012","volume":"67","author":"Shield KD","year":"2017","journal-title":"CA Cancer J Clin"},{"issue":"2","key":"ref6","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0148761","article-title":"The fraction of cancer attributable to ways of life, infections, occupation, and environmental agents in Brazil in 2020","volume":"11","author":"Azevedo E Silva G","year":"2016","journal-title":"PLoS One"},{"issue":"6","key":"ref7","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1016\/j.oooo.2020.08.021","article-title":"Prevalence of p16 expression in oropharyngeal squamous cell carcinoma in southern Brazil","volume":"130","author":"Girardi FM","year":"2020","journal-title":"Oral Surg Oral Med Oral Pathol Oral Radiol"},{"issue":"1","key":"ref8","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1002\/hed.25985","article-title":"Impact of human papillomavirus status on survival and recurrence in a geographic region with a low prevalence of HPV-related cancer: A retrospective cohort study","volume":"42","author":"De Cicco R","year":"2020","journal-title":"Head Neck"},{"key":"ref9","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.canlet.2020.02.023","article-title":"Hpv impact on oropharyngeal cancer patients treated at the largest cancer center from Brazil","volume":"477","author":"Buexm LA","year":"2020","journal-title":"Cancer Lett"},{"issue":"9","key":"ref10","doi-asserted-by":"crossref","first-page":"1968","DOI":"10.1002\/ijc.30608","article-title":"Geographic heterogeneity in the prevalence of human papillomavirus in head and neck cancer","volume":"140","author":"Anantharaman D","year":"2017","journal-title":"Int J Cancer"},{"issue":"4","key":"ref11","first-page":"461","article-title":"Human papillomavirus (HPV) 16 and the prognosis of head and neck cancer in a geographical region with a low prevalence of HPV infection","volume":"25","author":"L\u00f3pez RVM","year":"2014","journal-title":"Cancer Causes Control"},{"issue":"10","key":"ref12","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.1002\/cncr.28595","article-title":"What is the best treatment for patients with human papillomavirus-positive and -negative oropharyngeal cancer?","volume":"120","author":"Urban D","year":"2014","journal-title":"Cancer"},{"issue":"18","key":"ref13","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.1200\/JCO.19.00370","article-title":"Evolution of the Oropharynx Cancer Epidemic in the United States: Moderation of Increasing Incidence in Younger Individuals and Shift in the Burden to Older Individuals","volume":"37","author":"Tota JE","year":"2019","journal-title":"J Clin Oncol"},{"key":"ref14","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1016\/j.oraloncology.2016.11.011","article-title":"The role of HPV on the risk of second primary neoplasia in patients with oropharyngeal carcinoma","volume":"64","author":"Martel M","year":"2017","journal-title":"Oral Oncol"},{"issue":"5","key":"ref15","first-page":"645","article-title":"Influence of the persistence of tobacco and alcohol use in the appearance of second neoplasm in patients with a head and neck cancer. 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Cancer Causes Control"},{"key":"ref31","series-title":"Vigitel Brasil 2006-2023: tabagismo e consumo abusivo de \u00e1lcool: vigil\u00e2ncia de fatores de risco e prote\u00e7\u00e3o para doen\u00e7as cr\u00f4nicas por inqu\u00e9rito telef\u00f4nico: estimativas sobre frequ\u00eancia e distribui\u00e7\u00e3o sociodemogr\u00e1fica de fatores de risco e prote\u00e7\u00e3o para doen\u00e7as cr\u00f4nicas nas capitais dos 26 estados brasileiros e no Distrito Federal entre 2006 e 2023","year":"2023"},{"issue":"12","key":"ref32","doi-asserted-by":"crossref","first-page":"1899","DOI":"10.1185\/03007995.2012.746218","article-title":"Incidence of second primary malignancies in patients with treated head and neck cancer: a comprehensive review of literature","volume":"28","author":"Atienza JAS","year":"2012","journal-title":"Curr Med Res Opin"},{"issue":"10","key":"ref33","doi-asserted-by":"crossref","first-page":"2390","DOI":"10.1002\/ijc.23798","article-title":"Risk of second primary cancer among patients with head and neck cancers: A pooled analysis of 13 cancer registries","volume":"123","author":"Chuang S","year":"2008","journal-title":"Int J Cancer"},{"issue":"5","key":"ref34","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1007\/s11604-021-01231-4","article-title":"Radiotherapy for HPV-related cancers: prediction of therapeutic effects based on the mechanism of tumor immunity and the application of immunoradiotherapy","volume":"40","author":"Someya M","year":"2022","journal-title":"Jpn J Radiol"},{"issue":"12","key":"ref35","doi-asserted-by":"crossref","first-page":"1544","DOI":"10.1093\/jnci\/djad169","article-title":"Global epidemiologic patterns of oropharyngeal cancer incidence trends","volume":"115","author":"Zumsteg ZS","year":"2023","journal-title":"J Natl Cancer Inst"},{"issue":"4","key":"ref36","doi-asserted-by":"crossref","first-page":"579","DOI":"10.1177\/0194599813496373","article-title":"Second Cancer Incidence, Risk Factor, and Specific Mortality in Head and Neck Squamous Cell Carcinoma","volume":"149","author":"Lee DH","year":"2013","journal-title":"Otolaryngol Head Neck Surg"},{"key":"ref37","series-title":"Pol\u00edtica Nacional de Sa\u00fade Bucal: a\u00e7\u00f5es estrat\u00e9gicas para implementar as diretrizes da Lei no. 14.572\/23","year":"2025"},{"issue":"4","key":"ref38","first-page":"1663","article-title":"The effect of preventive oral care on treatment outcomes of a cohort of oral cancer patients","volume":"24","author":"Morais MO","year":"2016","journal-title":"Support Care Cancer"},{"issue":"14","key":"ref39","doi-asserted-by":"crossref","first-page":"1606","DOI":"10.1200\/JCO.2016.71.8478","article-title":"Head and Neck Cancer Survivorship Care Guideline: American Society of Clinical Oncology Clinical Practice Guideline Endorsement of the American Cancer Society Guideline","volume":"35","author":"Nekhlyudov L","year":"2017","journal-title":"J Clin Oncol"},{"issue":"3","key":"ref40","doi-asserted-by":"crossref","first-page":"2937","DOI":"10.1007\/s00784-021-04276-x","article-title":"Including dental professionals in the multidisciplinary treatment team of head and neck cancer patients improves long-term oral health status","volume":"26","author":"Bertl K","year":"2022","journal-title":"Clin Oral Investig"},{"issue":"3","key":"ref41","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1016\/S1470-2045(23)00013-X","article-title":"Prognostic implications of p16 and HPV discordance in oropharyngeal cancer (HNCIG-EPIC-OPC): a multicentre, multinational, individual patient data analysis","volume":"24","author":"Mehanna H","year":"2023","journal-title":"Lancet Oncol"}],"container-title":["Revista Brasileira de Epidemiologia"],"original-title":["Perfil cl\u00ednico e padr\u00e3o de segundos tumores prim\u00e1rios em c\u00e2ncer de orofaringe HPV-positivo e HPV-negativo"],"link":[{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_pdf&pid=S1415-790X2026000101040&tlng=en","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:47:34Z","timestamp":1786963654000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S1415-790X2026000101040&tlng=en"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026]]},"references-count":41,"alternative-id":["S1415-790X2026000101040"],"URL":"https:\/\/doi.org\/10.1590\/1980-549720260046","relation":{},"ISSN":["1980-5497","1415-790X"],"issn-type":[{"value":"1980-5497","type":"electronic"},{"value":"1415-790X","type":"print"}],"subject":[],"published":{"date-parts":[[2026]]},"article-number":"e260046"}}