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Emerging epidemiological data indicate a rising global incidence of human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC). Serology for early HPV antigens has been highlighted as a relevant biomarker for HPV-associated OPSCC. This study aimed to determine the seroprevalence of HPV16 E6 antibodies in HNSCC patients in the state of Esp\u00edrito Santo, Brazil. Methods: This is a prospective longitudinal cohort study in which 287 patients with HNSCC were enrolled, recruited from two oncology centers in Esp\u00edrito Santo between 2011 and 2018, along with 68 cancer-free individuals. Serum samples were analyzed using the HPV16 E6 GST Capture ELISA assay. Statistical analysis was performed using SPSS. Binary logistic regression was employed to identify independent predictors of seropositivity. Results: The overall seroprevalence of HPV16 E6 antibodies was 7.3%. Seropositivity was observed in tumors of the oral cavity (6.2%) and oropharynx (13.3%). Patients with OPSCC demonstrated a significantly higher likelihood of seropositivity compared to those with tumors of the oral cavity, larynx, and hypopharynx (OR = 2.96, 95% CI: 1.21\u20137.28, p = 0.018). The highest frequency of HPV16 E6-positive cases occurred in tumors of the palatine tonsils (OR = 6.00; 95% CI: 1.58\u201322.89; p &lt; 0.009). No seropositive cases were observed in hypopharyngeal or laryngeal tumors. Among patients with OPSCC and oral cavity squamous cell carcinoma (OCSCC), HPV16 E6 serostatus did not significantly correlate with sociodemographic, behavioral, or clinical tumor characteristics. Conclusions: Our findings reinforce the predilection of HPV-associated carcinogenesis for the oropharynx, more specifically in the palatine tonsils. In addition, this study highlights HPV16 E6 serology as a potential biomarker for HPV-driven OPSCC and underscores Brazil\u2019s epidemiological heterogeneity, warranting standardized clinical validation.<\/jats:p>","DOI":"10.3390\/jcm15093557","type":"journal-article","created":{"date-parts":[[2026,5,7]],"date-time":"2026-05-07T09:03:37Z","timestamp":1778144617000},"page":"3557","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low HPV16 E6 Seroprevalence in HNSCC: A Prospective Study in Brazil"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8315-3077","authenticated-orcid":false,"given":"Enes Buck Mutiua Cantala","family":"Xavier","sequence":"first","affiliation":[{"name":"Faculty of Health Sciences, Zambeze University, Beira 2300, Mozambique"},{"name":"Biotechnology Post-Graduation Program Rede Nordeste\u2014RENORBIO, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3992-5986","authenticated-orcid":false,"given":"Camila Batista","family":"Daniel","sequence":"additional","affiliation":[{"name":"Biotechnology Post-Graduation Program, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Priscila Marinho","family":"de Abreu","sequence":"additional","affiliation":[{"name":"Biotechnology Post-Graduation Program, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3221-3057","authenticated-orcid":false,"given":"Isabella Bittencourt","family":"do Valle","sequence":"additional","affiliation":[{"name":"Biotechnology Post-Graduation Program, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brena Ramos","family":"Athaydes","sequence":"additional","affiliation":[{"name":"Biotechnology Post-Graduation Program, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frederico Firme","family":"Figueira","sequence":"additional","affiliation":[{"name":"Molecular Pathology Laboratory, Pathology Department, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agenor","family":"Sena","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Division, Santa Rita de C\u00e1ssia Hospital, Vit\u00f3ria 29043-260, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evandro Duccini","family":"de Souza","sequence":"additional","affiliation":[{"name":"Head and Neck Surgery Division, Santa Rita de C\u00e1ssia Hospital, Vit\u00f3ria 29043-260, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tim","family":"Waterboer","sequence":"additional","affiliation":[{"name":"Infections and Cancer Epidemiology, German Cancer Research Center (Deutsches Krebsforschungszentrum), 69120 Heidelberg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8897-5747","authenticated-orcid":false,"given":"Sandra Ventorin","family":"von Zeidler","sequence":"additional","affiliation":[{"name":"Biotechnology Post-Graduation Program Rede Nordeste\u2014RENORBIO, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"},{"name":"Biotechnology Post-Graduation Program, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"},{"name":"Molecular Pathology Laboratory, Pathology Department, Health Sciences Center, Federal University of Esp\u00edrito Santo, Vit\u00f3ria 29040-090, Esp\u00edrito Santo, Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,6]]},"reference":[{"key":"ref_1","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","year":"2024","journal-title":"CA Cancer J. Clin."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"S43","DOI":"10.1016\/j.canep.2016.03.012","article-title":"Head and Neck Cancer Burden and Preventive Measures in Central and South America","volume":"44","author":"Perdomo","year":"2016","journal-title":"Cancer Epidemiol."},{"key":"ref_3","unstructured":"Instituto Nacional de C\u00e2ncer (2022). Estimativa 2023: Incid\u00eancia de C\u00e2ncer no Brasil."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1002\/hed.23942","article-title":"Rising Prevalence of Human Papillomavirus-Related Oropharyngeal Cancer in Australia over the Last 2 Decades","volume":"38","author":"Hong","year":"2016","journal-title":"Head. Neck"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1583","DOI":"10.1002\/hed.25585","article-title":"Changes in Incidence and Prevalence of Human Papillomavirus in Tonsillar and Base of Tongue Cancer during 2000-2016 in the Stockholm Region and Sweden","volume":"41","author":"Haeggblom","year":"2019","journal-title":"Head. Neck"},{"key":"ref_6","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":"Georges","year":"2020","journal-title":"Lancet Glob. Health"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1002\/ijc.32871","article-title":"Global Trends in Oral and Pharyngeal Cancer Incidence and Mortality","volume":"147","author":"Bosetti","year":"2020","journal-title":"Int. J. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Menezes, F.S.M., Latorre, M.R.D.O., Concei\u00e7\u00e3o, G.M.S., Curado, M.P., Antunes, J.L.F., and Toporcov, T.N. (2020). The Emerging Risk of Oropharyngeal and Oral Cavity Cancer in HPV-Related Subsites in Young People in Brazil. PLoS ONE, 15.","DOI":"10.1371\/journal.pone.0232871"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"105177","DOI":"10.1016\/j.oraloncology.2020.105177","article-title":"Global Incidence Trends in Head and Neck Cancer for HPV-Related and-Unrelated Subsites: A Systematic Review of Population-Based Studies","volume":"115","author":"Menezes","year":"2021","journal-title":"Oral. Oncol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"4550","DOI":"10.1200\/JCO.2013.50.3870","article-title":"Worldwide Trends in Incidence Rates for Oral Cavity and Oropharyngeal Cancers","volume":"31","author":"Chaturvedi","year":"2013","journal-title":"J. Clin. Oncol."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"3235","DOI":"10.1200\/JCO.2015.61.6995","article-title":"Epidemiology of Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma","volume":"33","author":"Gillison","year":"2015","journal-title":"J. Clin. Oncol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"204","DOI":"10.3892\/ijo.2015.2990","article-title":"Trends and Regional Variation in the Incidence of Head and Neck Cancers in England: 2002 to 2011","volume":"47","author":"McCarthy","year":"2015","journal-title":"Int. J. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4294","DOI":"10.1200\/JCO.2011.36.4596","article-title":"Human Papillomavirus and Rising Oropharyngeal Cancer Incidence in the United States","volume":"29","author":"Chaturvedi","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Gorphe, P., Blanchard, P., Garcia, G.C.T.E., Classe, M., Even, C., Temam, S., and Breuskin, I. (2022). 2011\u20132021 Rising Prevalence of HPV Infection among Oropharyngeal Carcinoma in France. BMC Cancer, 22.","DOI":"10.1186\/s12885-022-10091-8"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"13219","DOI":"10.1038\/s41598-020-70118-7","article-title":"Epidemiology of Human Papillomavirus-Related Oropharyngeal Cancer in a Classically Low-Burden Region of Southern Europe","volume":"10","author":"Mena","year":"2020","journal-title":"Sci. Rep."},{"key":"ref_16","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":"Levi","year":"2014","journal-title":"Cancer Causes Control"},{"key":"ref_17","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","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1697","DOI":"10.1158\/1055-9965.EPI-21-0016","article-title":"HPV-Induced Oropharyngeal Squamous Cell Carcinomas in Brazil: Prevalence, Trend, Clinical, and Epidemiologic Characterization","volume":"30","author":"Carvalho","year":"2021","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"E132","DOI":"10.1055\/s-0041-1730297","article-title":"Progressive Increase Trend in HPV-Related Oropharyngeal Squamous Cell Carcinoma in Brazil","volume":"26","author":"Pires","year":"2022","journal-title":"Int. Arch. Otorhinolaryngol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"84","DOI":"10.9734\/jammr\/2023\/v35i195143","article-title":"Human Papillomavirus (HPV) Prevalence in Oropharynx Squamous Cell Carcinomas (OPSCC) in Brazil: A Systematic Review with Meta-Analysis","volume":"35","author":"Ferreira","year":"2023","journal-title":"J. Adv. Med. Med. Res."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"375","DOI":"10.5935\/1808-8694.20130065","article-title":"Gen\u00f3tipos de V\u00edrus de Papiloma Humano Em Carcinoma de C\u00e9lulas Escamosas de Cabe\u00e7a e Pesco\u00e7o Na Col\u00f4mbia","volume":"79","author":"Quintero","year":"2013","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"761","DOI":"10.1002\/cncr.31841","article-title":"The Prevalence of Human Papillomavirus in Oropharyngeal Cancer Is Increasing Regardless of Sex or Race, and the Influence of Sex and Race on Survival Is Modified by Human Papillomavirus Tumor Status","volume":"125","author":"Faraji","year":"2019","journal-title":"Cancer"},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Carlander, A.F., Jakobsen, K.K., Bendtsen, S.K., Garset-Zamani, M., Lynggaard, C.D., Jensen, J.S., Gr\u00f8nh\u00f8j, C., and von Buchwald, C. (2021). A Contemporary Systematic Review on Repartition of HPV-Positivity in Oropharyngeal Cancer Worldwide. Viruses, 13.","DOI":"10.3390\/v13071326"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"11","DOI":"10.1016\/j.oraloncology.2016.09.004","article-title":"Pathology-Based Staging for HPV-Positive Squamous Carcinoma of the Oropharynx","volume":"62","author":"Haughey","year":"2016","journal-title":"Oral Oncol."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Brooks, J.M., Zheng, Y., Hunter, K., Willcox, B.E., Dunn, J., Nankivell, P., Gevaert, O., and Mehanna, H. (2024). Digital Spatial Profiling Identifies Distinct Patterns of Immuno-Oncology-Related Gene Expression within Oropharyngeal Tumours in Relation to HPV and P16 Status. Front. Oncol., 14.","DOI":"10.3389\/fonc.2024.1428741"},{"key":"ref_26","doi-asserted-by":"crossref","unstructured":"Conarty, J.P., and Wieland, A. (2023). The Tumor-Specific Immune Landscape in HPV+ Head and Neck Cancer. Viruses, 15.","DOI":"10.3390\/v15061296"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"274","DOI":"10.1016\/j.semradonc.2021.02.009","article-title":"Biology of the Radio- and Chemo-Responsiveness in HPV Malignancies","volume":"31","author":"Spiotto","year":"2021","journal-title":"Semin. Radiat. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1093\/jnci\/djn011","article-title":"Improved Survival of Patients with Human Papillomavirus-Positive Head and Neck Squamous Cell Carcinoma in a Prospective Clinical Trial","volume":"100","author":"Fakhry","year":"2008","journal-title":"J. Natl. Cancer Inst."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1056\/NEJMoa0912217","article-title":"Human Papillomavirus and Survival of Patients with Oropharyngeal Cancer","volume":"363","author":"Ang","year":"2010","journal-title":"N. Engl. J. Med."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"2861","DOI":"10.1158\/1078-0432.CCR-14-3323","article-title":"HPV Serum Antibodies as Predictors of Survival and Disease Progression in Patients with HPV-Positive Squamous Cell Carcinoma of the Oropharynx","volume":"21","author":"Dahlstrom","year":"2015","journal-title":"Clin. Cancer Res."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"2442","DOI":"10.1002\/cncr.33505","article-title":"Survival Advantage in Patients with Human Papillomavirus-Driven Oropharyngeal Cancer and Variation by Demographic Characteristics and Serologic Response: Findings from Head and Neck 5000","volume":"127","author":"Whitmarsh","year":"2021","journal-title":"Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e115","DOI":"10.5858\/arpa.2024-0388-CP","article-title":"Human Papillomavirus Testing in Head and Neck Carcinomas Guideline Update","volume":"149","author":"Lewis","year":"2025","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1097\/CCO.0000000000001029","article-title":"Advances in Testing for Human Papillomavirus-Mediated Head and Neck Cancer","volume":"36","author":"Mehanna","year":"2024","journal-title":"Curr. Opin. Oncol."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"S75","DOI":"10.1007\/s12105-012-0369-0","article-title":"P16 Immunohistochemistry as a Standalone Test for Risk Stratification in Oropharyngeal Squamous Cell Carcinoma","volume":"6","author":"Lewis","year":"2012","journal-title":"Head Neck Pathol."},{"key":"ref_35","unstructured":"Amin, M.B., Edge, S.B., Greene, F.L., Byrd, D.R., Brookland, R.K., Washington, M.K., Gershenwald, J.E., Compton, C.C., Hesseltine, C.F., and Devita, V.T. (2024). AJCC Cancer Staging System, American College of Surgeons. [9th ed.]."},{"key":"ref_36","first-page":"93","article-title":"The Eighth Edition AJCC Cancer Staging Manual: Continuing to Build a Bridge from a Population-based to a More \u201cPersonalized\u201d Approach to Cancer Staging","volume":"67","author":"Amin","year":"2017","journal-title":"CA Cancer J. Clin."},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Hibbert, J., Halec, G., Baaken, D., Waterboer, T., and Brenner, N. (2021). Sensitivity and Specificity of Human Papillomavirus (Hpv) 16 Early Antigen Serology for Hpv-Driven Oropharyngeal Cancer: A Systematic Literature Review and Meta-Analysis. Cancers, 13.","DOI":"10.3390\/cancers13123010"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"2748","DOI":"10.1002\/ijc.30697","article-title":"Sensitivity and Specificity of Antibodies against HPV16 E6 and Other Early Proteins for the Detection of HPV16-Driven Oropharyngeal Squamous Cell Carcinoma","volume":"140","author":"Holzinger","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"106676","DOI":"10.1016\/j.oraloncology.2023.106676","article-title":"Detection of Serum Biomarkers of HPV-16 Driven Oropharynx and Oral Cavity Cancer in Brazil","volume":"149","author":"Sichero","year":"2024","journal-title":"Oral Oncol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"489","DOI":"10.1093\/ije\/dyq249","article-title":"Low Human Papillomavirus Prevalence in Head and Neck Cancer: Results from Two Large Case\u2013Control Studies in High-Incidence Regions","volume":"40","author":"Ribeiro","year":"2011","journal-title":"Int. J. Epidemiol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1136\/bmj.39335.541782.AD","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: Guidelines for reporting observational studies","volume":"335","author":"Altman","year":"2007","journal-title":"BMJ"},{"key":"ref_42","unstructured":"Fritz, A.G. (2000). International Classification of Diseases, World Health Organization. [3rd ed.]."},{"key":"ref_43","unstructured":"Edge, S.B., Byrd, D.R., Compton, C.C., Fritz, A.G., Greene, F.L., and Trotti, A. (2010). AJCC Cancer Staging Manual, Springer. [7th ed.]."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0022-1759(01)00376-3","article-title":"A Generic Capture ELISA for Recombinant Proteins Fused to Glutathione S-Transferase: Validation for HPV Serology","volume":"253","author":"Sehr","year":"2001","journal-title":"J. Immunol. Methods"},{"key":"ref_45","doi-asserted-by":"crossref","unstructured":"Rahman, M.M., Bose, S., Chen, L., Burris, J.L., Aouad, R., Arnold, S.M., Yeoh, M., Michels, B., Waterboer, T., and Lang Kuhs, K.A. (2025). Performance of Dried Blood Spot Cards for Serologic Detection of HPV16 Antibodies in Oropharyngeal Squamous Cell Carcinoma Patients. Microorganisms, 13.","DOI":"10.3390\/microorganisms13112558"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"4382","DOI":"10.1002\/cncr.30966","article-title":"Human Papillomavirus 16 E6 Antibodies Are Sensitive for Human Papillomavirus\u2013Driven Oropharyngeal Cancer and Are Associated with Recurrence","volume":"123","author":"Kreimer","year":"2017","journal-title":"Cancer"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"508","DOI":"10.1016\/0042-6822(92)90453-V","article-title":"Antibodies to HPV-16 E6 and E7 Proteins as Markers for HPV-I 6-Associated Invasive Cervical Cancer","volume":"187","author":"Muller","year":"1992","journal-title":"Virology"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Crowther, J.R. (2001). The ELISA Guidebook, Humana Press. [2nd ed.]. Methods in Molecular Biology.","DOI":"10.1385\/1592590497"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1007\/s12105-024-01713-7","article-title":"Human Papillomaviruses 16 and 18 E6 Oncoprotein Detection Test in Primary Oropharyngeal Carcinomas and Metastatic Lymph Nodes: A Cross-Sectional Study","volume":"18","author":"Polesel","year":"2024","journal-title":"Head Neck Pathol."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"306","DOI":"10.1038\/s41571-022-00603-7","article-title":"HPV-Associated Oropharyngeal Cancer: Epidemiology, Molecular Biology and Clinical Management","volume":"19","author":"Lechner","year":"2022","journal-title":"Nat. Rev. Clin. Oncol."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"7835","DOI":"10.1038\/s41467-024-51679-x","article-title":"Smoking and Alcohol by HPV Status in Head and Neck Cancer: A Mendelian Randomization Study","volume":"15","author":"Thakral","year":"2024","journal-title":"Nat. Commun."},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1016\/j.bjorl.2016.01.004","article-title":"Papilomav\u00edrus Humano (HPV) em Carcinomas de Cavidade Oral e Orofaringe na Regi\u00e3o Central do Brasil","volume":"83","author":"Petito","year":"2017","journal-title":"Braz. J. Otorhinolaryngol."},{"key":"ref_53","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","year":"2020","journal-title":"Oral Surg. Oral Med. Oral Pathol. Oral Radiol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"2069","DOI":"10.1002\/ijc.34444","article-title":"A Risk Prediction Model for Head and Neck Cancers Incorporating Lifestyle Factors, HPV Serology and Genetic Markers","volume":"152","author":"Budhathoki","year":"2023","journal-title":"Int. J. Cancer"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"2161","DOI":"10.1007\/s11845-024-03715-4","article-title":"HPV Overtakes Smoking as the Leading Cause of Oropharyngeal Cancer in Ireland: Experience of a Head and Neck Surgery Tertiary Referral Centre","volume":"193","author":"Cleere","year":"2024","journal-title":"Ir. J. Med. 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