The PHORECAST (Hamburg HPV Oropharyngeal Cancer Screening Study) – A current update and outlook

Introduction  Despite the rising incidence of oropharyngeal cancer attributable to human papillomaviruses (HPV-OPC) over the last decades, early detection is still challenging. Antibodies against HPV16 early proteins are detectable years prior to HPV-OPC diagnosis. Our proof-of-concept study allowed identifying three stage I HPV-OPC patients, out of eleven participants considered at high risk within the Hamburg City Health Study (HCHS) until June 2022.

Patients and methods  The study is embedded within the HCHS, a single center, prospective, epidemiologic cohort study that started enrolling 45.000 participants (45-74 years) in 2016. Using multiplex serology to analyze the first 4,424 participants’ sera, 11 participants (0.3%) seropositive for HPV16 E6 and at least one additional early protein (E1, E2, E7) were considered at high risk for HPV-OPC development and invited to non-invasive head and neck follow-up (FU) exams. 24 participants were single HPV16 E6 seropositive.

Results Currently (10/2022) one more female participant was identified and treated with asymptomatic HPV-OPC (cT2 cN1 cM0). One male participant presented (11/2022) with asymptomatic progressive asymmetric hyperplasia of the base of the tongue and is planned for magnetic resonance imaging and panendoscopy with biopsy. The remaining participants showed no detectable signs of cancer, and undergo regular FU. The 24 participants single HPV16 E6 seropositive are planned for FU including anogenital examination beginning in early 2023.

Conclusion  Detection of multiple HPV16 early antibodies so far allowed identifying four asymptomatic stage I HPV-OPC patients and might be an innovative method to identify such patients at an early stage, reduce morbidity and improve quality of life.

Publication History

Article published online:
12 May 2023