Guo F et al. – This study provides the strongest epidemiologic evidence to date in support of the important role of human papillomavirus (HPV) in the development of esophageal squamous cell carcinoma (ESCC) in high–incidence areas of China.

• A total of 300 patients with ESCC and 900 controls matched for age and sex were enrolled in Anyang (China), a high-risk area for ESCC in China.
• In tumor tissue of the cases and in esophageal biopsies of controls, the presence of human papillomavirus (HPV) DNA was assessed by an SPF1/GP6+-mediated PCR followed by sequencing.
• The presence of serum antibody against the HPV-16 E7 oncoprotein was assessed by use of the ELISA.
• ORs with 95% confidence intervals (CI) were calculated via unconditional logistic regression models.

• The presence of HPV in the esophagus (OR, 6.4; 95% CI, 4.4-9.2) was associated with increased risk of ESCC.
• Moreover, infection with “oncogenic” types of HPV (OR, 10.3; 95% CI, 6.3-16.8) was more strongly associated with ESCC than other types of HPV (OR, 2.4; 95% CI, 1.4-4.2).
• The presence of HPV-16 (OR, 12.8; 95% CI, 7.6-21.7) was particularly strongly associated with ESCC.
• In addition, a higher proportion of cases than controls had serum antibodies against HPV-16 E7 (OR, 6.1; 95% CI, 3.7-10.0).