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Some people can have elevated levels of p16 but test negative for HPV and vice versa. This is known as discordant cancer. The 5-year survival for people who test positive for HPV and p16 is 81%, for discordant cancer it is 53 – 55%, and 40% for those who test negative for p16 and HPV. [209] [210]
However, some people can have elevated levels of p16 but test negative for HPV and vice versa. This is known as discordant cancer. The 5-year survival for people who test positive for HPV and p16 is 81%, for discordant cancer it is 53–55%, and 40% for those who test negative for p16 and HPV. [33] [34]
People with HPV-positive oropharyngeal cancer tend to have higher survival rates. [1] [6] However, HPV is tested for by the presence of the biomarker p16, which normally increases in the presence of HPV. Some people can have elevated levels of p16 but test negative for HPV and vice versa. This is known as discordant cancer.
The highest-risk types are HPV 16 and 18; these are responsible for the vast majority of HPV-related cancers, including cancers of the cervix, vagina, vulva, penis, anus, and head and neck.
Because HPV type 16 is the most common type found in oropharyngeal cancer, p16 immunohistochemistry is one test option used to determine if HPV is present, [135] which can help determine course of treatment since tumors that are negative for p16 have better outcomes.
The study revealed that based on the HPV status of the patient, for STAGE III and STAGE IV oropharynx carcinoma, there was a discrepancy in survival after three years. The survival was 82% in HPV positive and then also 57% in HPV negative cancers. [citation needed]
There are observed biological differences between HPV-positive and HPV-negative head and neck cancer, for example in terms of mutation patterns. In HPV-negative disease, genes frequently mutated include TP53, CDKN2A and PIK3CA. [73]
Cervical adenocarcinoma is less likely to be caused by high-risk HPV strains than cervical squamous cell carcinoma is: around 10-15% of cervical adenocarcinomas are non-HPV-related. Cervical clear cell carcinoma (CCC) is typically HPV-negative, though many are p16 positive. [3]