{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T08:52:05Z","timestamp":1791535925480,"version":"4.3.4"},"reference-count":32,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T00:00:00Z","timestamp":1649980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Introduction: Human papilloma virus (HPV)-related oropharyngeal carcinoma (OPC) can be considered a new subtype of cancer with different clinical characteristics and prognosis than that related to tobacco. Its incidence is increasing worldwide. Its epidemiology has been widely studied in areas such as North America and Northern Europe, but less is known in Southern Europe. Methods: We analyzed the epidemiology of OPC using the database from Girona\u2019s population-based Cancer Registry, in the North-East of Spain, from 1994 to 2018. To analyze differences between neoplasms related to human papillomavirus or not, we determined the immunohistochemical expression of p16 in cases within four time periods: 1997\u20131999, 2003\u20132005, 2009\u20132011, and 2016\u20132018. Results: Oropharyngeal cancer incidence increased significantly from 2001 to 2018 with an Annual Percentage of Change (APC) of 4.1. OPC p16-positive cases increased with an APC of 11.1. In the most recent period, 2016\u20132018, 38.5% of OPC cases were p16-positive. European age-standardized incidence rate was 4.18 cases\/100.000 inhabitants-year for OPC cancer and 1.58 for those p16-positive. Five-year observed survival was 66.3% for p16-positive OPC and 37.7% for p16-negative. Conclusions: Although with lower burden than in other regions, p16-positive oropharyngeal cancer is increasing in our area and has a better prognosis than p16-negative OPC.<\/jats:p>","DOI":"10.3390\/ijerph19084802","type":"journal-article","created":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T07:42:41Z","timestamp":1650094961000},"page":"4802","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Population-Based Analysis of Trends in Incidence and Survival of Human Papilloma Virus-Related Oropharyngeal Cancer in a Low-Burden Region of Southern Europe"],"prefix":"10.3390","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3516-6970","authenticated-orcid":false,"given":"Jordi","family":"Rubi\u00f3-Casadevall","sequence":"first","affiliation":[{"name":"Medical Oncology Department, Catalan Institute of Oncology, Hospital Josep Trueta, 17007 Girona, Spain"},{"name":"Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain"},{"name":"School of Medicine, University of Girona (UdG), 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elna","family":"Ciurana","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Girona (UdG), 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9961-3699","authenticated-orcid":false,"given":"Montserrat","family":"Puigdemont","sequence":"additional","affiliation":[{"name":"Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain"},{"name":"Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6269-5491","authenticated-orcid":false,"given":"Arantza","family":"Sanvisens","sequence":"additional","affiliation":[{"name":"Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain"},{"name":"Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jordi","family":"Marruecos","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Girona (UdG), 17004 Girona, Spain"},{"name":"Radiotherapy Oncology Department, Catalan Institute of Oncology, Hospital Josep Trueta, 17007 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Josefina","family":"Mir\u00f3","sequence":"additional","affiliation":[{"name":"Pathology Department, Girona Clinic, 17007 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antoni","family":"Urban","sequence":"additional","affiliation":[{"name":"Pathology Department, Corporaci\u00f3 de Salut del Maresme La Selva, Hospital Sant Jaume de Calella, 08370 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa-Lisset","family":"Palhua","sequence":"additional","affiliation":[{"name":"Pathology Department, Serveis de Salut Integrats Baix Empord\u00e0, Palamos Hospital, 17230 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferran","family":"Mart\u00edn-Romero","sequence":"additional","affiliation":[{"name":"Pathology Department, Fundaci\u00f3 Salut Emporda, Figueres Hospital, 17600 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8973-0493","authenticated-orcid":false,"given":"Maria Rosa","family":"Ortiz-Duran","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Girona (UdG), 17004 Girona, Spain"},{"name":"Pathology Department, Catalan Institute of Health, Hospital Josep Trueta, 17007 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9824-3657","authenticated-orcid":false,"given":"Rafael","family":"Marcos-Gragera","sequence":"additional","affiliation":[{"name":"Descriptive Epidemiology, Genetics and Cancer Prevention Group, Girona Biomedical Research Institute (IDIBGI), 17190 Girona, Spain"},{"name":"School of Medicine, University of Girona (UdG), 17004 Girona, Spain"},{"name":"Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan Department of Health Government of Catalonia, Catalan Institute of Oncology, 17004 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1772","DOI":"10.1093\/jnci\/djg107","article-title":"Human Papillomavirus and Oral Cancer: The International Agency for Research on Cancer Multicenter Study","volume":"95","author":"Herrero","year":"2003","journal-title":"J. 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