Changing epidemiology and survival of HPV-associated oropharyngeal cancer in Denmark: four decades of population-based data
- 1Department of Otolaryngology, Head and Neck Surgery & Audiology, Copenhagen University Hospital – Rigshospitalet
Abstract
Background: Oropharyngeal squamous cell carcinoma (OPSCC) has undergone substantial epidemiological and clinical changes, with an increasing proportion of human papillomavirus (HPV)-associated tumours and declining tobacco exposure. We investigated temporal changes in patient characteristics, HPV/p16 status, treatment patterns, and survival among patients with OPSCC in Denmark.
Methods: Patients with OPSCC were identified from the Copenhagen Oropharyngeal Cancer Database (2000–2023) and the Danish National Patient Cancer Registry (DCR; 1980–2021). The Copenhagen database provided detailed clinical and pathological data, including HPV/p16 status, while the DCR enabled assessment of long-term survival trends. Temporal changes were evaluated across diagnostic periods. Overall survival, relative survival, and restricted mean survival time were estimated.
Results: Among 3,631 OPSCC patients in the Copenhagen database, median age at diagnosis increased from 59 years in 2000–2005 to 64 years in 2018–2023 (p<0.001). The proportion of HPV+/p16+ patients increased significantly from 43.5% in 2000–2005 to 62.8% in 2018-2023. The proportion of never smokers also increased from 0.5% to 23.5%, while ≥20 pack-years decreased from 73.2% to 52.1% (p<0.001). Treatment patterns changed substantially, with radiotherapy alone decreasing from 87.6% to 27.9% and chemoradiotherapy increasing from 1.6% to 46.3%. Among 9,379 patients in the DCR, five-year relative survival increased from 31.8% in 1980–1984 to 70.1% in 2015-2019. Among HPV+/p16+ patients, five-year overall survival increased from 63.1% in 2000–2005 to 83.7% in 2018–2023.
Conclusion: In Denmark, OPSCC has undergone substantial epidemiological and therapeutic changes accompanied by marked improvements in survival, including among HPV+/p16+ patients.
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BibTeX
@article{jakobsen2026changing,
title = {{Changing epidemiology and survival of HPV-associated oropharyngeal cancer in Denmark: four decades of population-based data}},
author = {Kathrine Kronberg Jakobsen and Jakob Myllerup Jensen and Joachim Hansen and Christian von Buchwald and Christian Grønhøj},
journal = {Frontiers in Oncology},
year = {2026},
month = oct,
doi = {10.3389/fonc.2026.1982354},
url = {https://www.frontiersin.org/articles/10.3389/fonc.2026.1982354/full},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Changing epidemiology and survival of HPV-associated oropharyngeal cancer in Denmark: four decades of population-based data
AU - Kathrine Kronberg Jakobsen
AU - Jakob Myllerup Jensen
AU - Joachim Hansen
AU - Christian von Buchwald
AU - Christian Grønhøj
PY - 2026
DA - 2026/10/15
JO - Frontiers in Oncology
DO - 10.3389/fonc.2026.1982354
UR - https://www.frontiersin.org/articles/10.3389/fonc.2026.1982354/full
AB - Background: Oropharyngeal squamous cell carcinoma (OPSCC) has undergone substantial epidemiological and clinical changes, with an increasing proportion of human papillomavirus (HPV)-associated tumours and declining tobacco exposure. We investigated temporal changes in patient characteristics, HPV/p16 status, treatment patterns, and survival among patients with OPSCC in Denmark. Methods: Patients with OPSCC were identified from the Copenhagen Oropharyngeal Cancer Database (2000–2023) and the Danish National Patient Cancer Registry (DCR; 1980–2021). The Copenhagen database provided detailed clinical and pathological data, including HPV/p16 status, while the DCR enabled assessment of long-term survival trends. Temporal changes were evaluated across diagnostic periods. Overall survival, relative survival, and restricted mean survival time were estimated. Results: Among 3,631 OPSCC patients in the Copenhagen database, median age at diagnosis increased from 59 years in 2000–2005 to 64 years in 2018–2023 (p<0.001). The proportion of HPV+/p16+ patients increased significantly from 43.5% in 2000–2005 to 62.8% in 2018-2023. The proportion of never smokers also increased from 0.5% to 23.5%, while ≥20 pack-years decreased from 73.2% to 52.1% (p<0.001). Treatment patterns changed substantially, with radiotherapy alone decreasing from 87.6% to 27.9% and chemoradiotherapy increasing from 1.6% to 46.3%. Among 9,379 patients in the DCR, five-year relative survival increased from 31.8% in 1980–1984 to 70.1% in 2015-2019. Among HPV+/p16+ patients, five-year overall survival increased from 63.1% in 2000–2005 to 83.7% in 2018–2023. Conclusion: In Denmark, OPSCC has undergone substantial epidemiological and therapeutic changes accompanied by marked improvements in survival, including among HPV+/p16+ patients.
SN - 2234-943X
ER -