Is there a higher prevalence of human papillomavirus infection in Chinese laryngeal cancer patients? A systematic review and meta-analysis

Accumulating evidence suggests that persistent human papillomavirus (HPV) infection is closely related to the risk of certain types of head and neck squamous cell carcinoma types, including laryngeal cancer (LC). Some reports indicated a higher HPV prevalence in Chinese LC patients, which remains to be established due to small study sample sizes. The aim of this study was to estimate the HPV infection rate in Chinese LC patients and assess the LC risk conferred by high-risk subtype HPV infection by meta-analysis. We searched MEDLINE, the Embase Database, Chinese National Knowledge Infrastructure, Wanfang Database, and VIP Database for studies published in either English or Chinese up to October 2013, and systematically reviewed 28 original research articles that met the inclusion criteria. Both the HPV infection rate in the LC group (all 28 studies) and the LC risk from high-risk HPV infection (a subgroup of 12 case-control studies) were analyzed by R 3.0 software. Overall HPV, HPV-16/18, and HPV-6/11 infection rates were 32 % (95 % CI 22-44 %), 30 % (95 % CI 24-37 %), and 12 % (95 % CI 9-17 %), respectively. There was a strong association between high-risk HPV-16/18 infection and LC (P < 0.01; OR = 8.07, 95 % CI 5.67-11.48). Our research indicates that there is a higher HPV prevalence in Chinese LC patients compared to LC patients outside of China and that HPV infection significantly increases LC risk.