Human Papillomavirus Testing in Head and Neck Carcinomas: Guideline Update

Area of Science:

• Pathology
• Oncology
• Virology

Background:

• The College of American Pathologists (CAP) published an evidence-based guideline in 2018 for high-risk human papillomavirus (HPV) and surrogate marker testing in head and neck carcinomas.
• New evidence necessitates an update, including data on HPV in nonoropharyngeal sites, global HPV rates, p16 immunohistochemistry, and HPV testing in cytology specimens.

Purpose of the Study:

• To assess research published since the 2018 guideline.
• To update evidence-based recommendations for HPV testing in head and neck carcinomas.

Main Methods:

• A CAP expert panel convened to update the guideline, adhering to National Academy of Medicine standards.
• Key questions were defined, and a systematic literature review was conducted.
• The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to update recommendations based on evidence certainty and expert judgment.

Main Results:

• The guideline update includes seven strong recommendations, four conditional recommendations, and five good practice statements.
• New research on sinonasal squamous cell carcinoma is incorporated.
• Guidance is expanded for specific scenarios and practice settings.

Conclusions:

• The updated statements offer direction on HPV testing in diverse head and neck specimens.
• The goal is to enhance and standardize HPV testing across various pathology practices and international settings.